AAL Forum 2009

Innovative ICT Solutions for Older
Persons – A New Understanding
Proceedings of the AAL FORUM 09 Vienna
[email protected]
Band 04
Wissenschaftliches Redaktionskomitee
o.Univ.Prof.Dr. Gerhard Chroust
Univ.Prof.Dr. Gabriele Kotsis
Univ.Prof. DDr. Gerald Quirchmayr
Univ.Doz.Dr. Veith Risak
Dr. Norbert Rozsenich
o.Univ.Prof.Dr. Peter Zinterhof
Univ.Prof. Dr. Jörg Zumbach
Gerda Geyer, Reinhard Goebel, Kerstin Zimmermann (eds.)
Innovative ICT Solutions for Older
Persons – A New Understanding
Proceedings of the AAL FORUM 09 Vienna
© Österreichische Computer Gesellschaft 2010
Layout: Leopold Hayer
Proofreading: Mary Stegmüller
© Österreichische Computer Gesellschaft
Komitee für Öffentlichkeitsarbeit
www.ocg.at
Druck: Druckerei Riegelnik
1080 Wien, Piaristengasse 19
ISBN 978-3-902580-07-8
TABLE OF CONTENTS
INTRODUCTION..............................................................................................................................7
Forum Committee ...........................................................................................................................8
Acknowledgements .........................................................................................................................9
Foreword .......................................................................................................................................11
The Ambient Assisted Living Joint Programme Member States Addressing the Common
Problem of the Ageing Society .....................................................................................................19
OPENING AND PLENARY ...........................................................................................................21
Welcome Note by the Austrian Host of the AAL Forum .............................................................23
Innovative ICT Solutions for Older Persons – a New Understanding ..........................................25
Ageing Well in the Information Society .......................................................................................27
Building a Bridge between Hospital and Home through Technology ..........................................32
AAL Market Development – Barriers and Carriers ......................................................................36
SESSIONS.........................................................................................................................................41
AAL Projects I ..............................................................................................................................43
AAL Projects II .............................................................................................................................45
AAL JP Participation Rules ..........................................................................................................50
Healthy Ageing .............................................................................................................................55
Active Ageing ...............................................................................................................................60
Labour-Saving Innovations: Contributions from the UK, Denmark and the Netherlands............65
Programme benefit: Launch of the Fifth Call for Proposals .........................................................70
End-User Involvement ..................................................................................................................74
Ethical Issues.................................................................................................................................79
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Business Models............................................................................................................................83
AAL as a Chance for Innovation...................................................................................................87
Standards and Interoperability ......................................................................................................91
Roadmapping/Technology Trends in AAL...................................................................................96
WORKSHOPS ...............................................................................................................................101
Workshop for Young Researchers and PhD ...............................................................................103
The Workshop on Business Models............................................................................................105
ARTICLES .....................................................................................................................................109
Programme benefit: Public Funding in the Thematic Area of AAL in Austria ..........................111
The Living Situation of Older People in Austria Compared to Other European Countries........117
Overview of the European Strategy in ICT for Ageing Well .....................................................125
Technology Adoption by Older Adults: Usability Plus X ..........................................................132
Ambient Assisted Living: Resources and Barriers .....................................................................138
CompiSternli – Kids Teaching Elderly People ...........................................................................143
The Need for Interoperability and Standards in AAL.................................................................150
Projections of Future Long-Term Care Expenditure in Austria (2008-2030) with Special
Consideration of Assistive Technologies ....................................................................................156
Active Ageing in the Community – AAL and Mobility .............................................................164
ANNEX ...........................................................................................................................................171
Speakers and Chairs ....................................................................................................................173
Ambient Assisted Living Joint Programme AAL JP: The First Call for Proposals AAL-2008-1
.....................................................................................................................................................176
Benefit Projekte 2008 - Benefit Projects Funded in 2008..........................................................185
Projects Presented at the Young Researchers' and PhD Workshop ............................................194
Participants ..................................................................................................................................204
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INTRODUCTION
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FORUM COMMITTEE
Chair: Reinhard Goebl, AAL Vice President, Federal Ministry of Transport, Innovation and
Technology, AT
Paolo Dario, Scuola Superiore Sant´Anna, IT
Gerhard Finking, AAL President, DE
Gerda Geyer, AAL-NCP, Austrian Research Promotion Agency (FFG), AT
Urs Guggenbühl, FHS St. Gallen, CH
Holly Jimison, Oregon Health & Science University, Portland, USA
Pekka Kahri, Chair AAL Working Group Content, TEKES, FI
Ilse Kryspin-Exner, University of Vienna, AT
Geja Langerveld, AAL-NCP, ZonMw, NL
Jackie Marshall-Cyrus, Technology Strategy Board, UK
Claus Nielsen, Medcom, DK
Silas Olsson, VINNOVA, SE
Christian Wehrmann, VDI/VDE Innovation + Technik GmbH, DE
Peter Wintlev-Jensen, European Commission, BE
Wolfgang Zagler, Vienna University of Technology, AT
Kerstin Zimmermann, Federal Ministry of Transport, Innovation and Technology, AT
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ACKNOWLEDGEMENTS
What you are now holding in your hands are the proceedings of the first ever Forum event of the
Ambient Assisted Living Joint Programme. The event was entitled Ambient Assisted Living Forum
09 and took place in Vienna from September 29th to October 1st, 2009.
We would like to take the opportunity to express our deep gratitude to everybody who contributed
to the proceedings. First of all, we thank the FORUM Committee Members and the chair of the
FORUM Committee, Reinhard Goebl, who were first responsible for shaping and organising the
Forum and then for writing and collecting summaries and additional contributions. Thank you also
to all the chairs of the sessions and to the speakers who depicted a manifold picture of the Ambient
Assisted Living topical field. Finally, thank you to all the authors of the texts, be it session
summaries, articles or annex compilations.
In particular, we have to thank Gerda Geyer very much for her excellent editing of this volume. We
also have to thank Kerstin Zimmermann, Alexandra Kuhn and Eugen Muehlvenzl, Chair of the
Organising Group, for their permanent commitment enabling the success of the AAL FORUM
Vienna 09.
The proceedings contain five contributions of the opening and plenary of the Forum 09, fifteen
summaries of sessions and workshops, nine extra articles and five annex contributions.
We hope you will appreciate the variety of information and insight which the proceedings offer.
Gerhard Finking, President, AAL Association, organiser of the AAL FORUM
Gerald Futschek, President, Austrian Computer Association, publisher
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FOREWORD
In autumn 2009, the “AAL Forum Vienna 2009” took place in the Imperial Palace in the heart of
Vienna. This was the first of a series of events of this type organised in cooperation with the
Ambient Assisted Living Joint Programme (AAL JP) and a European Member State of the
programme , in this case Austria.
The Ambient Assisted Living Joint Programme (AAL JP) was launched in 2008. It was the result of
the common European vision combining innovative Information and Communication Technologies
(ICT) and a new approach to cooperation based on Article 169 of the European Treaty which fosters
close cooperation of national and regional initiatives. The Programme aims to enhance the quality
of life of older persons utilising ICT and strengthening the industrial base in Europe. Technology is
seen as one possibility for shaping our future in times of demographic change and living longer. It is
seen as a possible means to keep ourselves healthy and active for even longer.
Through the exploration of the possibilities that technology offers us, Ambient Assisted Living
(AAL) can contribute to extend the time we will be able to live in our preferred home environment
and can assist us in our daily activities within our information society.
Technology is not a singular solution in shaping a society conducive to ageing. A “new
understanding” of its potential is necessary to get closer to the users and to involve them directly in
the development of this new technology.
The Forum was designed to outline in three different tracks what was felt to be crucial information
and discussion for promoting the potential of the common initiative. The three tracks were 1) the
Ambient Assisted Living Joint Programme itself, 2) some of the national and regional initiatives in
the field as well as 3) the innovative and socio-economic aspects of AAL. In addition, workshops
were held and there was a vast exhibition area; poster sessions gave insight into funded projects and
social events facilitated new contacts and cooperation partners.
In short, the Forum aimed to offer a broad variety of opportunities to manifold information, to
exchange views and to find potential partners for future cooperation.
As the final decision for publishing the proceedings was communicated when the Forum was almost
completed, speakers and chairs could only be invited to contribute to the proceedings afterwards.
Returning to normal routine, sometimes results in difficulty finding time to look back and
summarise what had happened. The proceedings therefore do not include all the sessions and
contributions. However, it does give a good overview of the contributions and discussions which
made the Forum a most lively and informative event.
Following the basic outline of the Forum, additional articles written by various authors were
collected in order to give more detailed information and to investigate crucial issues more fully.
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Finally, compilations of funded projects in the First Call of the AAL JP and in the Austrian national
Programme benefit will give a good overview on relevant topics and approaches. Short abstracts of
the projects presented by the Young Researchers show a very promising profile of investigations in
the vast AAL field.
Proceedings Contributions
Opening and Plenary
The opening speeches reflect the political relevance of the AAL Joint Programme (AAL JP). Due to
the high level and important involvement of the European institutions, opening speeches were given
by senior representatives of the member states, for the Vienna Forum, Austria, from the European
Council represented by Sweden, holding the current presidency and from the European
Commission. The speakers were respectively Ingolf Schädler (BMVIT), Thomas Lagerwall
(SIAT) and Mary Veronica Tovsak Pleterski (EC).
The keynote speech of Jeroen Wals introduced “An Industrial Vision of AAL”. What are the
challenges, the competition structures? Does a European stronghold exist or is it just a global
market?
Open questions regarding the “AAL Market Developments – Barriers and Carriers” were also
the centre of the Industrial Round Table which was moderated by the Chair of the AAL Advisory
Board, Peter Saraga. The composition of the participants in the Round Table discussion was
designed to represent a vast experience in the field of R&D, technology developments, industry and
market considerations, social innovations, and the financial reality in public procurement.
Sessions
Track 1: The Ambient Assisted Living Joint Programme
The First Call of AAL Joint Programme, entitled “ICT- based Solutions for the Prevention and
Management of Chronic Conditions of Elderly People” was launched in 2008. Michael Huch and
Silas Olsson, both staff members of the Central Management Unit of the AAL Association, chaired
two sessions on “AAL Projects”, in which 12 successful consortia could briefly present their
projects.
The AAL Joint Programme is a new type of R&D funding programme in Europe. It is based on
joining the activities of its partner states on the theme of Ambient Assisted Living which is
supported by a financial contribution from the EC through Article 169 of the Treaty. As experience
among the member countries in the AAL JP demonstrates, there is still much need to sort out the
participation rules and basic requirements of projects in the AAL JP. The session on the “AAL JP
Participation Rules” was dedicated to that topic and chaired by Pekka Kahri from the Finnish
Funding Agency Tekes.
AAL Joint Programme has some characteristics that make it different to other European initiatives
that are addressing the questions of demographic ageing:
1. AAL aims at launching R&D activities that have a 2-3 years period time to market. It tries to fill
the gap between research activities and market introduction of new products, systems and services.
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2. AAL emphasises the role of end-users and especially older persons as active participants in the
projects.
3. AAL stresses the importance of market analysis and business model development in the projects
in order to boost market introduction of new products and services and systems that are being
developed.
The session focussed on the participation rules of the AAL Joint Programme and the specific
requirements of business models and end-user involvement.
The ageing population poses a great challenge to Europe’s economic and social development. As
people are living longer and longer it is of paramount importance that costs for medical and social
care will not explode and that individuals can enjoy their lives in good health for as long as
possible. Not only does healthy ageing represent challenges to society and individuals – it also
offers opportunities for economic growth based on new technologies, products and services.
Challenges and opportunities in healthy ageing – was the subject addressed and discussed in the
session “Healthy Ageing”, chaired by Uli Waibel, managing director of the consulting firm
Innovendo.
We live in an information society. Information and communication technologies (ICT) permeate
almost every aspect of our lives. They can be powerful tools for bringing people together, for
adding new values to life, creating new wealth, health and welfare, thus accounting for a richer and
more rewarding professional and social life.
The other side of the coin is that in Europe (and elsewhere) millions of people cannot fully reap
these benefits and a significant percentage is effectively cut off from them for a variety of reasons:
geographical, social, economic, educational, cultural, physical or cognitive disabilities and age, etc.
The potential for AAL solutions related to the topic of “Active Ageing” is high. The interesting
discussion was chaired by Antonio Mendes dos Santos from UMIC, Portugal, and showed that
some very interesting aspects could be defined.
Track 2: National and Regional Aspects
Countries with different backgrounds and objectives participate in AAL. For some countries an
important driver is the economic opportunity for their national companies, others are especially
interested in the possibilities of e-health and telecare. Some want to close the gap between digital
development and older people, others expect ICT/technology to solve future workforce problems.
The session “Intelligent Solutions: How to Save Time and Costs” was organised around the
“labour-saving effects” of ICT innovation which is highly relevant when looking at an ageing
population and decreasing numbers of young people to serve them or take care of them.
Nevertheless, the labour-saving objective is quite a sensitive issue. The session was chaired by
Thomas Børner from the Danish Ministry of Finance.
Some of the European countries have – parallel to the AAL Joint Programme – their own national
programmes aimed at the development of innovative and smart ICT for older people. One such
programme is the Austrian national R&D funding programme benefit which opened the Fifth Call
for Proposals during the AAL Forum in Vienna. The “Launch of the Fifth Call for Proposals”
was chaired by Programme Manager Gerda Geyer, FFG. The session was designed to give insight
into the genesis, the implementation and the thematic background of programme benefit and its
focus on “ICT-based Solutions for Advancement of Active Ageing”. Similar to the WHO definition
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of active ageing, the Austrian programme benefit defines “active ageing” as a process which
enhances the quality of life of the individual by maximising access to participation / social
integration, security and health.
The involvement of end-users is a major issue in the AAL JP - and for good reasons. The session
“End-user Involvement”, chaired by Barbara von der Linden, ZonMw, The Netherlands, was
dedicated to different aspects of the topic. AAL solutions have to be ‘wanted’ by older people and
their families and also by the carers or service providers that are supposed to work with the
solutions or the organisations that have to provide or finance them. Although general studies on
needs and wishes of older people can definitely give insights and directions, it is not sufficient.
Only the real involvement of the different types of end-users can realise real solutions.
In the successive stages of the designing process, the role of end-users will differ; varying from
expressing needs to testing usability and assessing usefulness of solutions. In all phases serious
involvement of end-users can highly contribute to the quality of the solutions and the marketability
and implementation of the products and services. In AAL technologies a lot of questions concerning
ethical issues arose. As always, issues like safety and reliability of systems, privacy regarding entry
to and exchange of data are at stake. Smart surroundings, constant monitoring of different body
functions or activity levels can help to save people in emergency situations, but it also can keep
people under constant surveillance. What does this mean for people and how does it affect their
lives and relationships? What do telecare solutions mean for the quality of care, for personal contact
and for the quality of work? What action is to be taken if people are not able to give informed
consent? How can the dignity of older people be guaranteed?
How does the use of smart technology affect personal relations with family and friends? What is the
effect of living in ‘your own little hospital at home’?
The debate about these issues has hardly begun and was taken up at the AAL Forum in the Session
on “Ethical Issues in AAL”, chaired by Antonio Mendes dos Santos.
Track 3: Innovation and Economy
In Europe the environment of national health care and social security systems is rather
heterogeneous. This hinders the development of common (European) business models and a
common market for AAL solutions. Taking into consideration the importance and the potential of
the topic, a session on “Business Models” was offered at the AAL Forum, which was chaired by
Juan Carlos Castrosin Gutierrez, CEO of Platform of Investments and Powerful Inventions
PI&PI and Member of the AAL Advisory Board. Currently, reimbursement schemes in most
countries do not encourage the adoption of technological innovations in these systems and provide
no clear perspective to link investments and revenues/savings for adopters. Investors and developers
have to deal with a wide variety of welfare, healthcare and care systems in European countries.
Each of these systems provides a complex legal and regulatory basis which restricts or encourages
the use of AAL technology in the public healthcare and care services in specific ways. In both the
more regulated markets of healthcare/care and the consumer-oriented private markets, the lack of
visible value chains is obvious. The complex structure of the developing AAL markets and the lack
of market information and visible value chains make it difficult for SME or entrepreneurs to
develop possible business strategies and evaluate the future market potential in this sector. To foster
the market entry and participation of (innovative) SME and start-up companies in these important
(technology and service oriented) market segments, it is important to foster innovation and
14
deployment in the whole of the AAL ecosystem. The session aimed to describe possible business
models, provide information on the “ageing market” and current successful examples from the SME
sector.
Urs Guggenbühl, Director of the Innovation Centre of the University of Applied Sciences, St.
Gallen chaired the session on “AAL as a Chance for Innovation”. The convergence of an ageing
population with today’s availability of advanced technology is an opportunity to innovate and to
think differently about how we live throughout our life span. The home is the primary platform for
much of life’s activities influencing health, wellness, well-being, independence and safety as we
age. Sometimes though, technology seems an attractive option when we are faced with an
improvement challenge. The AAL JP aims to catalyse innovation in exploiting technology to
provide not only products but services that are needed, desired and financeable to enhance the lives
of older people among member states. It recognises that technology is a tool that complements
abilities and has the potential to allow our ageing population to do more and become more
productive.
Standardisation is a prerequisite for a broad deployment and the use of ICT and will trigger and
enable new business. This is particularly true in the context of AAL technology. There are many
different subjects for AAL technology standards, for example, hardware, technologies, software,
interfaces/architectures, processes, services, data, content, etc. Each may require a different
approach, or involve different actors and methods. Establishing such standards economises on
coordination costs, creates an integrated market with economy-of-scale advantages and helps to
build trust in quality of devices and services where error-free functioning can be critical to the
individual. Another approach to achieve the necessary interoperability is certification on product
level. The session on “Standards and Interoperability” was chaired by Jeroen Wals, Vice
President of Philips Research Healthcare Program and Member of the AAL Advisory Board.
In recent years, the European Commission and European member states have made considerable
investments in ICT and research into ageing in the Framework Programme, the AAL Joint
Programme and national initiatives. Similar approaches have emerged in other geographical
regions, e.g., Australia, Canada, Japan and the United States. Further research needs to build on
these results and to be guided by a trends assessment and roadmaps which provide an extended look
at the future of active ageing and ageing well in the information society. This requires interaction
between various technology areas and innovative technology approaches. Information and
knowledge about mid/long-term R&D perspectives will be crucial for defining future R&D steps on
the way to Ambient Assisted Living.
Several ongoing and soon to be completed FP7 roadmapping projects – AALIANCE, CAPSIL,
ePAL, and SENIOR – have addressed different and complementary perspectives of ICT and ageing.
The session on “Trends and Roadmapping in AAL” presented their approaches towards a
comprehensive vision and strategic roadmaps. The session was chaired by Christian Wehrmann,
VDI/VDE-IT and AALIANCE Coordinator.
Workshops
“The Young Researcher and PhD Workshop” was held by Ilse Kryspin Exner, University of
Vienna. The workshop offered the opportunity to meet other young researchers from Europe and to
15
learn more about the variety of projects dealing with the investigation of technical solutions for
older adults. Young researchers had the opportunity to present ideas, designs and results of research
studies, and to discuss the projects with other students and young investigators under senior
scientists’ supervision. The interdisciplinary approach within various disciplines (geriatrics,
engineering, architecture, informatics, psychology, sociology, nursing sciences economics, etc.) was
particularly highlighted.
Business models are the main success factor for new enterprises in the AAL area. The workshop on
“Business Plans”, which was held by Urs Guggenbühl, tried to promote guidelines to develop
business models for AAL solutions. Experience shows that the focus in AAL projects is usually
much more on technical development, rather than on marketing to the user. However it is the user
who defines the success of the product. A business model looks at the needs of the market in respect
of the user and puts forward a value proposition – uniquely offering the customer a value chain
which defines the value of a product at each activity in the chain of development and a process how
to earn money so that the company which produces and offers the product can sustain itself.
The workshop elaborated on the questions: why are business models necessary for AAL solutions,
what concept is behind successful business models and how are our business models developed.
Articles
Austria was the country which co-organised the first Forum of the Ambient Assisted Living Joint
Programme. Austria was also one of the founding members of the AAL Association. The national
backbone programme for the Austrian participation in Article 169 Initiative Ambient Assisted
Living Joint Programme (AAL JP) is called programme “benefit”. Programme benefit is the first
Austrian mission-oriented thematic programme in the field of ICT. The programme was set up in
2007. The initial phase of the programme was dominated by activities to build up the community
and create a common understanding and common knowledge base. The first calls focussed on
“ICT-based Solutions for the Advancement of Active Ageing”. The paper “Programme benefit:
Public Funding in the Thematic Area of AAL in Austria by Gerda Geyer, Programme Manager
in charge of Programme benefit at the funding agency FFG and Kerstin Zimmermann,
representative of the programme-owning Ministry BMVIT gives insight into the rationale of the
first calls launched as well as into experiences made.
What is the living situation of older persons in Europe? Is it similar or does it differ greatly?
Isabella Buber-Ennser, researcher at the Vienna Institute of Demography, elaborates in her paper
under the title “The Living Situation of Older People in Austria Compared to Other European
Countries” the similarities and differences. The paper is based on the “Survey of Health, Ageing
and Retirement in Europe” (SHARE), a European dataset that includes accurate cross-national
information on economic circumstances, health, and well-being, integration into family and social
networks. Living conditions of older people in Austria compared to other European Countries are
presented, including family status, children and housing. As a financial indicator, the subjective
assessment of the economic situation of the household is presented for Austria as well as for the
other 10 European countries included in SHARE. Another main aspect of ageing is health,
focussing here on self perceived health and limitations in the “Activities of Daily Living” (ADL).
Finally, different aspects of social participation of the population aged 50 and older are presented
such as voluntary work or participation in a sport or other kinds of club activities.
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The EC is known to have funded several projects in the “Ageing Well” focus. What is the strategy
for the future? What is the background? Why is ICT for Ageing Well important? The paper by the
European Commission outlines the serious pressure which demographic change will put on
Europe’s social models and public finances without a higher level of participation of elder
population in employment and without better tailored and more effective health and social care
services. Information and Communication Technologies can play an important role in helping
Europe’s societies to age well. ICT can help older individuals to improve their quality of life, stay
healthier, live independently for longer, and counteract reduced capabilities which are more
prevalent with age. ICT can enable them to remain active at work or in their community. The paper
outlines the EU Action Plan for Ageing Well in the Information Society as well as The Future
Policy Framework for ICT & Ageing.
Anna Elisabeth Pohlmeyer from the University of Technology in Berlin und Lucienne Blessnig
from the University of Luxembourg elaborate in their paper on the “Technology Adoption by
Older Adults: Usability Plus X”. They are convinced that despite the prospect that technology can
enable prolonged independent living and active ageing, this will only hold true if older adults accept
the relevant technology and feel motivated to use it. The paper highlights the importance of usercentered design in the realm of gerontechnology in order to ensure technology adoption. It is being
argued that simply addressing usability-related issues is not sufficient to evoke the user’s interest
and willingness to adopt a system.
In the AAL field, the barriers for technology adoption quite often are the centre of attention.
Claudia Oppenauer and Ilse Kryspin Exner, both from the University of Vienna, Faculty for
Psychology, investigate the topic in the paper named “Ambient Assisted Living: Resources and
Barriers”. They state that the growing population of older people in industrial countries and
changing family structures demand affordable solutions in order to encourage old people in their
social participation and to satisfy their need to age in situ. Technology can be a significant resource
for older people if the users perceive a device or system as helpful and not stigmatising or too
complex. Technology acceptance not only depends on the needs and attitudes of older people but
also on age, gender, level of education and health, social and cultural conditions. Contrary to
stereotypes, old people are willing to use new technologies but acceptance and use are only
achieved if adequate training is provided and if the end-users experience subjective benefit from the
technology.
Rahel Tschopp describes in her paper entitled “CompiSternly – Kids Teaching Elderly People”
a Swiss project that shows very well one method by which older adults can become familiar with
computer usage. “CompiSternli” are children who offer computer and mobile phone courses to
elderly people. One child introduces the basics to one elderly person. The pace of the course is
determined by the elderly person. At the time of Rahel Tschopp writing the article, the project had
been running throughout Switzerland for one year.
A completely different view in the field of AAL comes from Ger van den Broek who works for
Philips Research Europe and is also a member in the AALIANCE project. The paper “The Need
for Interoperability and Standards in AAL” states that Ambient Assisted Living (AAL) is a very
broad application domain with the intention of allowing persons to live longer independently, taking
their chronic diseases, impairments and abilities into account, and giving them adequate support
while maintaining their privacy and dignity. The AAL domain concentrates on innovative
utilisation of ICT, new ways of user interaction or new types of value chains for independent-living
services. He identifies the need along two lines: the person needing support (elder or disabled
17
person) and persons delivering care (informal and professional care givers). Van den Broek argues
that different kinds of interoperability and standards are necessary to be able to develop
collaborative integrated services.
What is the potential economic impact of AAL in the care sector? Clemens Buchinger and Ulrike
Schneider, both from the Vienna University of Economics and Business, discuss in their paper
“Projections of Future Long-Term Care Expenditure in Austria (2008-2030) with Special
Consideration of Assistive Technologies” findings from cost projections for long-term care (LTC)
in Austria based on a macro simulation model, spanning the years 2008 to 2030. They also present
estimates for the cost-saving potential of assistive technologies (AT) in home care. Previous
international studies reveal that AT’s potential to substitute or supplement personal care is highly
task-specific and also depends on the characteristics of the specific devices. Accordingly, findings
on the economic benefit of AT are mixed. There is some indication but no clear evidence that AT
will be both efficient and cost-effective.
Last but not least among the articles, an excerpt from the AALIANCE Ambient Assisted Living
Roadmap focussing on “Active Ageing in the Community – AAL and Mobility” takes up two
important issues for high quality of life in old age. The article states that social participation
decreases with age, fundamentally because of three factors: intrapersonal, interpersonal and
structural factors. Despite all these factors, participation levels can be significantly increased with
adequate motivation and support. Thus, elderly people can be supported in finding and carrying
out work, establishing and maintaining contacts with other people, and, in general, can be helped to
spend time participating in different leisure activities. The excerpt mentions different ways by
which technologies in the AAL field can assist and support the individual physical mobility of older
persons.
Gerda Geyer
Reinhard Goebl
Kerstin Zimmermann
Vienna, March 2010
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THE AMBIENT ASSISTED LIVING JOINT PROGRAMME
MEMBER STATES ADDRESSING THE COMMON
PROBLEM OF THE AGEING SOCIETY
The demographic development and the ageing of the European population will lead to a growing
number of older people living alone and sometimes in need of intensive care, to a decreasing and
ageing workforce in general, and an increase in budgets for health and social care. The number of
people with physical and mental disabilities and particularly with chronic conditions will grow
rapidly. The problems of care and assistance to these people are becoming more and more important
from both the social and economic points of view.
They will bring dramatic challenges for healthcare and care systems, state pension schemes and
employers alike. All these trends and challenges are now amplified by the effects of the economic
and financial crisis, especially on the public budgets.
The challenges of demographic change cannot be approached with traditional policies and concepts.
By the year 2020 a first major impact of the demographic trend will be imposed on most societies in
Europe. The needs for immediate actions are even greater because many regions in Europe, both
urban and rural , will feel that impact earlier and harder. With regard to the decreasing workforce
for care and cure in particular, new technologies and new innovative systems solutions are
necessary, especially in the field of innovative ICT-enabled assisted living or “ambient assisted
living” (AAL) solutions. Europe has a high scientific, technological and industrial potential in these
technologies and systems.
From the many projects already carried out on national and European levels, it is well known that
AAL assistive technologies can help older individuals to improve their quality of life, to stay
healthier and to live longer in their preferred living environment, thus extending the active and
creative participation of individuals in the community.
The implementation and dissemination of new AAL solutions cannot be realised without close
interaction between the national systems, especially in the fields of healthcare, social care and
institutions supporting senior citizens and/or having high importance. Due to these strong
interrelations with national and regional actors and also because of the great similarities of problems
across all European countries, a new approach for a funding programme for innovations has been
applied. The AAL Joint Programme is a member state driven programme of 23 member states
according to Article 169 of the European Treaty. The Ambient Assisted Living (AAL) Joint
Programme (AAL JP) was set up in 2008 with budget support from the European Commission of
25 million euros and a total budget in the order of 55-60 million euros per year (2008 – 2013).
19
20
OPENING AND PLENARY
21
22
WELCOME NOTE BY THE AUSTRIAN HOST OF THE
AAL FORUM
Ingolf Schädler1
Dear ladies and gentlemen, representatives of the host ministry and the AAL Joint Programme, we
are pleased to welcome you to the “AAL FORUM Vienna 2009”.
The AAL Joint Programme (AAL JP) has been established based on an Article 169 co-decision
process. In the meantime, two calls have been published. The first call is already in operation, the
second is soon to be decided at the next general assembly. Our first experiences show promising
results giving us clear indications that the European Union will become a leading force on this
subject. Furthermore, we appreciate this form of international cooperation by learning more of the
approaches of the cooperating countries towards the demanding subject of innovative ICT
development in the context of an ageing society.
In our view, the Joint Programme has two strong elements: the topic of innovative ICT for elderly
people and the new way of European cooperation based on Article 169 which allows a very
disseminated approach. Both subjects should be seriously discussed and further developed in the
AAL community in order to improve the quality and scope of the Programme.
Austria, as one of the funding members of the AAL Programme is highly committed to the
transnational calls with 2.5 million euros per year. During the life time of the programme from 2008
to 2013, Austria will spend nearly 50 million euros on this topic including contributions in kind
from industry. Technology will contribute to face demographic change. Life expectancy and the
numbers of older people are increasing continuously. In 2000, 16% of the Austrian population was
older than 65. This proportion will double by 2050. On the other hand, the work force will decline
from a ratio of 1:2 to 1:4. Smart production technologies are considered to play a major role in
compensating the above-mentioned gap.
ICT as a generic technology diffuses through many fields. By having a strong focus on end-user
involvement, ambient-assisted technology can create cost efficiency for the social system of the
ageing society, mainly in the care sector.
Austria has strong expertise in the following three domains
• Social inclusion: communication
• Activities at home and outdoor: fitness
• Comfort & safety: smart homes, monitoring
and a strong background in research, development and system integration with a clear focus on
usability, telecommunication and visual detection. This raises a number of high-potential SMEs that
1
Mag. Ingolf Schädler, Austrian Federal Ministry of Transport, Innovation and Technology.
23
are part of the successful results of the first AAL call: in one third of all projects, Austrian partners
are represented and two are even coordinated by Austrian participants.
The national programme benefit started as early as 2007 in order to lay the ground work for the
AAL initiative. As co-founder and vice-president, Austria had a strong bond in the bi-lateral setting
up of the AAL Joint Programme.
I hope you feel inspired by this traditional location and make the first forum a huge success!
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INNOVATIVE ICT SOLUTIONS FOR OLDER PERSONS
– A NEW UNDERSTANDING
Tomas Lagerwall1
Europe faces many challenges such as the financial recession, the environment and the fast
demographic change. A generation of baby-boomers born in the 40s and early 50s will soon retire.
Not only is this a large group – many more people were for example born in Sweden between 1940
and 1949 than between 1930 and 1939 – they are well educated and their life style has been very
different from that of their parents’. Beatles and 1968 formed their youth!
About 17% of Sweden’s population have reached retirement age and figures are similar in some
other European countries. These figures are expected to increase in coming years and we may soon
say that one out of five Europeans is a retired person. The growing number of older people should
not only be seen as a problem – it is the concrete result of positive socio-economic development and
public health actions.
Previous generations have cared for their parents at home. The new generation of retired people will
not be cared for by their children! They want to be independent and live at home as long as
possible. How to solve this will be a real challenge for Europe and in many other parts of the world,
not the least in Japan and North America. Technology can play an important role in ensuring high
quality of life for the aging population. However, technology can’t solve everything but can be an
important tool. Personal care and interaction with other persons is crucial for us as human beings!
85% of Swedes today use computers and internet on a regular basis. It means that the technology is
in almost everybody’s hands and increasing. But let us not forget the 15% who do not use
computers and internet and let us not forget those who are old today – born in the 20s or earlier.
They may not accept or understand new technical equipment such as mobile phones, computerized
kitchen equipment, mobility and behaviour monitoring and alarms. Here is an ample possibility for
European industry together with older people, their organisations, relatives, national, regional and
local governments and other stakeholders to develop advanced but easy to use ICT based solutions.
Four out of five people who are 61 or older in Sweden have a mobile phone. These phones are not
always designed to meet the needs of older people; complicated to use, small and not so user
friendly buttons and displays difficult to read.
More contacts between industry and older consumers are needed as well as with researchers to
design accessible products. The society, national governments, regions, countries and municipalities
as well as the European Union could play an active role in promoting higher accessibility which
will make life easier and open new possibilities for large groups of older users.
1 Senior Adviser, The Swedish Institute of Assistive Technology (SIAT), E-mail: [email protected].
25
Many European countries including Sweden welcome the Ambient Assisted Living initiative and
this conference. We need to work together. Technical developments are too costly and complex to
be solved by individual countries. Europe with a population 500 million can take a lead and the
European industry is a crucial actor in this process.
The Swedish Institute of Assistive Technology, (SIAT), where I come from, wants to be an actor in
this process. The Institute is a national body in the field of technology for persons with disabilities
and older persons owned by the national government, represented by the Ministry of Health and
Social Welfare, and The Swedish Association of Local Authorities and Regions (SALAR).
I would like to conclude by congratulating the organizers, the Austrian Federal Ministry of
Transport, Innovation and Technology, the AAL Forum Committee and the AAL Secretariat in
Brussels and wish you all success in our important mission to enhance high quality of life for older
persons in Europe!
26
AGEING WELL IN THE INFORMATION SOCIETY
Mary Veronica Tovsak Pleterski
Dear Ladies and Gentlemen,
I would like to thank the Austrian Ministry for Transport, Innovation and Technology and the AAL
Association for inviting the European Commission to this first AAL conference since the launch of
AAL in 2008.
This is an excellent and timely initiative to gather the stakeholders to discuss the progress of the
programme and ICT for Ageing Well.
Let me begin by recalling the importance of this dealing with demographic change and how this
AAL programme came about.
Why is Demographic Change important?
Thanks to progress in science and improved living standards, Europe's citizens are living ever
longer, in better health and wealth. Average life expectancy has increased from 55 in 1920 towards
80 today. This is a tremendous achievement!
However, as we all know, demographic ageing poses significant financial sustainability challenges.
Today in Europe there are still for every retired person, 4 others in employment. By 2025 this will
drop to 3 to 1 and by 2050 to only 2 to 1!
The cost of pensions and care, especially for the growing group over 80's, is rising rapidly. This is
estimated to bring additional costs of up to 8% of GDP between now and 2050. It will be a common
challenge for the European countries to even maintain the present quality of life for elderly people
and their carers.
One example to illustrate this: the annual costs associated with Alzheimer's disease was already
more than 125 billion Euros in 2005. And that cost will rise further, as Alzheimer will become
increasingly prevalent with the growth of the over 80 population.
Our approach must be to make the promise of Information and Communication Technologies
become a reality. Namely, that ICT can play a significant role in addressing these challenges and
turn them into opportunities to improve the quality of life, reduce cost of health and social care,
facilitate ageing at work and open up major new opportunities and markets for our industry and in
particular for SMEs.
27
Already now, we see the potential of savings and improved quality of life that can be achieved with
ICT. I recently read the example of Herefordshire in the UK using social alarms and telecare, and
realising annual savings of 1000 euros per older person concerned with very positive perceptions of
both the elderly and their carers.
Another example is from the West Lothian authorities in Scotland who have used smart technology
in existing and newly built housing to join up their health and social care services. In doing so, they
have achieved a reduction in hospital stays, from 57 days to 9 days, and have reduced costs by a
factor of 3. Older people and their families like it because it gives them more independence. And it
costs less, too! We need to stimulate others to seek out similar benefits.
How did the AAL JP come about?
The AAL Joint Programme has a long history. Seven Member States under the lead of Germany
started working together in 2004 in an EC-funded project to define the focus and key organisational
and operational principles for a new joint R&D programme.
The European Commission then tabled in 2007 a proposal for financial support to the AAL Joint
Programme based on Article 169 of the Treaty, which was then adopted by the Council of Ministers
and the European Parliament in July 2008.
This joint research programme is a good example of pursuing the European Research Area policy
which aims to increase investment in research in Europe, amongst others by better coordination of
national research funding.
In this way AAL was established and could start in 2008.
Where do we stand today
It is quite remarkable that the AAL Joint Programme has managed to get operational in a rather
short timeframe, despite a very challenging political, financial and organisational set-up.
It is also encouraging to see that several of the basic principles of the programme appear to be
working.
I refer here to the scientific integration through the joint work programme, to the transparent
selection of proposals for funding based on excellence and to the financial commitments by the
participating countries. Even better, the participating countries have been increasing their financial
contribution well beyond the initially expected levels, which is a very encouraging sign in these
times of financial hardship.
The constituency has also reacted positively to the new programme, with more than 100 proposals
in each of the two first calls. I am particularly pleased to see an SME participation of more than
40% in the selected proposals of the second call for proposals.
This clearly demonstrates the interest and relevance of the programme and that the efforts invested
have been worthwhile.
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Nevertheless, there is neither room nor time for complacency. The time to contract needs to be
reduced and is a point of concern. Further efforts need to be made to improve the awareness about
the opportunities of the programme across all participating countries.
Wider context
Let me now focus on the wider context of the AAL Joint Programme. After all, the Programme
does not exist in isolation. It is linked to other research and innovation programmes and it fits in a
larger policy context. Let me briefly explain.
In terms of research and innovation, AAL is complementing both the EU's 7th Framework
Programme, or FP7, as well as the ICT Policy Support Programme part of the Competitiveness and
Innovation Programme, that is the CIP. This complementarity is in terms of time-to-market as well
as in terms of types of research and innovation.
AAL with its 2 to 3 years time-to-market sits in between the longer-term research in FP7 and the
market deployment work in the CIP.
In terms of type of research and innovation the FP7 addresses advanced research such as service
robotics. Clearly, this has a longer time perspective. AAL on its turn aims at practical, marketoriented research. And the CIP supports no research but only deployment and validation work.
More specifically, in the CIP already 10 larger scale pilot projects have been launched, involving
more than 30 regions in Europe. These deployment projects demonstrate the impact from existing
ICT solutions for prolonging independent living of elderly people with multiple chronic diseases
and early dementia. These CIP projects currently collect comprehensive socio-economic evidence
to support the case for investment.
Together, the AAL Joint Programme, the FP7 and the CIP will leverage research and innovation for
more than one billion Euros between 2008 and 2013 in the ICT & Ageing field together with public
and private stakeholders. This provides strong opportunities for the European ICT industry to make
Europe the hub for new global markets in this emerging field.
We also have a common technological strategy for these three programmes. I refer to the work by
the AALIANCE innovation platform. This is a promising initiative of 35 key stakeholders which
have developed a common vision and roadmap for R&D in the field of ICT for Ageing Well. This
will be very useful to help guide the future efforts in the Framework Programme, the AAL Joint
Programme, and the CIP Programme.
In policy terms, the AAL Joint Programme is part of the wider policy initiative on ICT for Ageing,
namely the Action Plan on Ageing Well in the Information Society, under the i2010 Information
Society Policy. The Action Plan aims to increase awareness about existing solutions for ageing well
with the help of ICT, promote the exchange of good practice and stakeholder coordination, identify
market conditions and barriers across Europe, stimulate uptake of proven solutions and invest in
research and innovation for the future solutions.
The Action Plan on its turn is closely linked to the European Commission's e-health strategy and
even more widely, to Europe's social and economic policies that address the challenges of the
ageing population.
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All together these policies and activities provide a significant push to accelerate the uptake of
solutions and creation of innovation and markets in the independent living and care sector.
Next Steps
So what are the next steps?
We will launch the mandatory mid-term review of the AAL programme by the end of the year. This
review will look into the performance of the programme against the political expectations set out in
the AAL decision and will report back to Council and the European Parliament at the end of 2010.
Indicators such as Member States financial commitments, SME participation and time to contract
are amongst the elements which will be measured.
We expect that the operation of the programme will be further streamlined in the coming time and
that procedures are optimised to ensure the maximum performance of the programme.
We should also soon see the first concrete results from the AAL projects. The actual impact on the
market should start to become visible as well. Such results will help to attract further investments
for commercialisation of project results through other sources of funding such as private capital, the
European Investment Bank, regional funding etc.
The AAL Joint Programme will also play a role as a case study for similar initiatives in other fields
as part of the ongoing preparation for the 8th Framework Programme. The ageing area is also well in
the picture of the ongoing development of the post-i2010 Information Society Policy of the
Commission.
Conclusions
I would like at this point to thank all the representatives from the Member States for their
exceptional personal commitment, in particular the first members of the AAL executive board
headed by Dr. Gerhard Finking formerly BMBF Germany and the people working in the Central
Management Unit without whom this initiative would not have been possible.
It is clear that demographic ageing is a major challenge for Europe but it is also a key opportunity to
create new markets for related products and services. Through initiatives like the AAL Joint
Programme it is possible to stimulate innovation and create markets, while helping Europe tackle
the demographic ageing challenge.
In the policy guidelines for the next Commission, European Commission President Barroso has
identified demographic ageing as a priority area. This forms a good basis for development of further
policies and initiatives in this field.
The AAL Joint Programme is an excellent example of a European initiative with high potential
impact, combining social innovation with business and employment benefits, and building on true
European collaboration.
I encourage everyone to continue the active support and good progress and can ensure you that the
European Commission remains committed to support the future endeavours in this field.
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I wish you a successful conference in the coming days here in this beautiful city.
Thank you for your attention.
31
BUILDING A BRIDGE BETWEEN HOSPITAL AND HOME
THROUGH TECHNOLOGY
Jeroen Wals1
The future of our healthcare system is a very important issue, not only in Europe, but all over the
world. By empowering patients with chronic disease to take an active role in the management of their
disease, home healthcare technologies have the potential to change the way we deliver care and to
allow people to live independently for as long as possible.
The challenge to keep our healthcare systems sustainable, cost effective and of high quality, is a real
puzzle. With many stakeholders involved – from patients and care providers to insurance companies
and governments – effective solutions will demand innovation, determination and a willingness to
embrace change. Every year, new treatments and medical technologies offer new hope to patients and
those who care for them, but rising healthcare costs and an increasing shortage of professional care
providers are already stretching many healthcare systems to their limits.
The underlying problem is the ‘graying’ of the world’s population. The demographic shift to older age
groups is taking healthcare systems into new territory, where many things are still unknown. What we
do know, however, is the size of the challenge. In the year 2000, 600 million people in the world were
over the age of 60. By 2006, it had risen to more than 700 million. By 2050 it is forecast that around 2
billion people will be over 60. Unfortunately for most of these people the prospect will not be a healthy
old age. The majority of them will be suffering from some form of chronic illness. More frighteningly
still, it has been projected that by 2050 half of the developed world’s population will be chronically ill2.
1. Cultural and political shifts
Today’s changing lifestyles and eating habits have significant consequences, both good and bad. Many
more people, for example, now choose to eat a diet that is low in saturated fats. However, bad habits
such as smoking are extremely persistent, while some beneficial lifestyle changes, such as regular
exercise, are often hard to accomplish. Especially significant for the elderly, traditional structures that
provided support for parents and grandparents, such as nearness to close family members, are breaking
down, making the elderly increasingly dependent on other forms of support. Due to the fact that they
live longer, elderly women are more likely to live alone and more prone to social isolation and
1
2
Vice President Philips Research.
UN Report, “World Population Ageing, 2007,” Department of Economic and Social Affairs, Population Division.
32
economic deprivation. In addition, the elderly often have multiple and complex care needs, putting
more pressure on healthcare systems because chronic and terminal care services are very expensive.
New technologies and novel ways to deliver home-based healthcare may be able to alleviate the costs
in both areas by reducing the cost of chronic and terminal care services while also helping to prevent
the need for hospitalization. Home-based healthcare could serve as a bridge between the hospital and
the home, enabling continued quality of care, better quality of life, longer independent living and more
cost-effective healthcare systems.
Technology may be one of the key enablers to improving the healthcare environment but technology
isn’t everything. Choosing the right applications and implementations are also key to success. We need
to take into account how people actually live and how they react to innovation. Change always leads to
an emotional response, particularly with respect to healthcare, because healthcare touches our ultimate
personal space – our bodies – as well as how we choose to live. In many cases, it even affects how we
choose to die. Getting public support for change can also be difficult. The majority of the population
does not yet have a problem, and as a result they are often against the change that is so urgently needed.
Later on in life, it’s a decision they may well regret.
2. Empowerment through education
The greatest challenge is to apply technology in such a way that it helps patients to help themselves. If
patients feel that they are in control and not simply people for whom or to whom things are done, it
opens the door to improving care at greater affordability and making more effective use of scarce
nursing and medical resources. Empowering patients to take control of their care is a product of
environment and psyche, in which education is key. When it comes to healthcare, empowered patients
are educated patients. The first step on the road towards home care and prolonged independent living is
therefore to get patients to believe in their ability to care for themselves, making them proactive in
looking after themselves and focused on preventing crises.
Enabled by technology, home healthcare systems will be able to provide many different services to
patients. However, it is extremely important that patients do not feel abandoned to these systems.
Physicians must play an instrumental part, not only in educating patients and including them in the
decision making process, but also by reassuring them that the traditional safety net will still be there
when it’s needed. One excellent way of successfully empowering older patients is to also empower
their family. These informal caregivers are equally in need of education to help them understand what
technology is available to help their loved ones and need to be trained on the type of equipment used.
Last but not least, doctors and nurses need to be educated about new innovations in home healthcare so
that they can recognize the benefits in improving patient outcomes, lessening workloads and increasing
productivity. If these healthcare professionals accept that technology can take over many of the routine
tasks that they currently perform, they will be able to spend more time on providing personalized highvalue care – more time dealing with the patient as a person and less time as a machine.
Education is often a key driver of broad cultural transformation and healthcare change is no different.
In addition to the patients, caregivers and clinicians who are directly involved in the care cycle,
33
political leaders and government officials who decide on healthcare policies must also be empowered
with knowledge. They are the ones who must be convinced that the traditional paradigm of hospitalbased care must be reformed to reflect the new economic and demographic realities and that healthcare
systems of the future will need to focus on prevention, screening and early diagnosis as much as they
do on late-stage intervention and aftercare. Of course, hospital care will continue to be the setting for
addressing serious clinical situations that require complex medical diagnosis and intervention, but
routine care, such as that provided by ongoing home-based health monitoring, will be preferable for
patients and probably more cost effective in the long term.
3. First steps on the road
So how far are we down the road to home healthcare today? One of the most obvious examples is
typified by Philips Lifeline – an easy to use medical alert service that can connect an elderly person in
distress with immediate help, call medical assistance and contact a neighbor or family as well. Getting
assistance via Lifeline is no more complicated than pushing a button on a wristband or pendant. Within
seconds, a trained responder answers the distress call, determines the patient’s needs and contacts the
necessary people for help. Lifeline and similar services make a significant difference to the ability of
older people to remain independent and in their own homes at relatively low cost. And for family
members who worry about their elderly relatives living alone, they provide welcome reassurance that
help is literally a touch of a button away.
While services such as Lifeline are designed to address crisis situations, Home Telehealth is pro-active
technology that empowers patients to prevent crisis situations. It also illustrates how home
telemonitoring technology can improve patient outcomes and be cost effective at the same time – a
win-win situation for both patients and clinicians. In a study of heart failure patients done by Tufts
Medical Center in the USA, researchers found a 72% reduction in hospital heart failure re-admissions
when using telemonitoring and 63% fewer cardiac re-admissions3. Another study carried out in three
European locations was equally positive, showing a 29% improvement in the survival rate of heart
patients when using telemonitoring. While these numbers are in themselves persuasive for medical
practitioners, the ease of use of this new technology will be critical to its acceptance by patients.
Also targeting heart failure patients, the MyHeart project and its successor project HeartCycle (both
European Framework projects involving large pan-European consortia from academia and industry) are
developing systems that monitor patients day and night and directly link to physicians using wireless
technology and modern communication infrastructures. Special focus is placed on the user-friendliness
of the entire solution. In particular, the HeartCycle project is focused on closing the loop between
patient and clinician by looking into the effects of each individual patient’s medication regime and
adherence to therapy.
4. Remaining patient-focused
At Philips, we believe in a holistic, patient-centered approach to healthcare that focuses on the entire
care cycle from disease prevention and screening through to diagnosis and treatment, therapy
3
SPAN-CHF II study conducted by Tufts-New England Medical Center, presented at the AHA, 2005.
34
monitoring and health management. Driving our healthcare solutions is a commitment to developing
and implementing new technologies that will empower both patients and providers alike.
For research in this field, we strongly believe in a comprehensive approach. We start by gaining user
insights, followed by the development of appropriate technology to solve the identified problems and
implementation in real-life scenarios to test the service propositions. Every step of the way, we interact
with the different stakeholders in order to improve the proposition.
In Home Healthcare, this cannot be done without also addressing innovations in service and business
models that will lead to new ways of delivering care as well as new and improved reimbursement
models. If we want to go beyond the pilot studies that address clinical and technical needs, viable
business models must exist.
All of us have a personal stake in building a healthcare bridge to the future by empowering patients and
clinicians with the technology of change. Demonstrating that technology can enable change is only one
part of the challenge. The greater challenge is to convince all stakeholders, from patients and clinicians
through to healthcare providers, policy makers and politicians, that change is necessary. Effective
education will undoubtedly be the key to ensuring that the right decisions are made.
Acknowledgement: Thanks go to Dr. Eric Silfen, Chief Medical Officer, Philips Healthcare, for preparing much of the
material contained in this article.
35
AAL MARKET DEVELOPMENT
– BARRIERS AND CARRIERS
Harald Jagos1
Chair of session: Peter Saraga, AAL Advisory Board
Introduction
The major current issues of AAL in general are how to transform the many good ideas and research
into products and services. One big task for every institution working in this area is to develop
sustainable business models.
Speakers - Short presentations
Volker Adams – Robert Bosch Healthcare
Volker Adams categorised telemedicine in three groups: “Doc-to-Doc” technologies/solutions, “Docto-Patient” technologies/solutions and “Social care, telecare”. This is in line with their target market
(for future years): people with chronic diseases. Therefore, the guiding principle of Robert Bosch
Healthcare is: “We enhance the quality of life for people with chronic conditions.” and “We are the
preferred partner for telemedical solutions.”
Robert Bosch Healthcare wants to achieve an improvement in therapy management and the availability
of care and they also see a high potential for an overall cost reduction in the healthcare sector. This
could be done if 1. acute events/hospitalisations were reduced, 2. the number of high risk patients were
reduced and 3. the limited resources were utilised more efficiently.
They are currently focussing their work on clinician and patient interfaces and clinical content as well
as data acquisition and analysis.
Alexander Kollreider – Tyromotion, AT
Alexander Kollreider is managing director of Tyromotion, Austria, which is a rather young enterprise
that was only founded in 2007. They now employ 13 people. Their formula for success is to cooperate
with and involve medical partners from an early stage.
1
CEIT RALTEC, Institute of Rehabilitation and Assisted Living Technologies, Schwechat, Austria.
36
However, one big problem is the high production costs and the resulting high prices (10.000 to 300.000
euros) of their products. In order to find customers who could afford their developments, they chose a
rather small but promising market, namely rehabilitation clinics in particular. After a while on the
market, the intention is also to reach therapists and ultimately the home market.
They offer two systems and a third is almost ready for the market: 1. “Amadeo” which is designed for
hand rehabilitation (e.g. for stroke patients), 2. “Pablo” can be used for rehabilitation purposes as well
as for measurements. 3. a gait training system which is being developed.
Irina Odnoletkova – Independent Health Insurance Fund, BE
Irina Odnoletkova started with a simply true/fundamental and thought-provoking statement. On the one
hand, there is a constantly ageing society and, on the other hand, there is the budget deficit. This is
common for most European countries. Even though this is a rather simple dilemma, the solution is
obviously not as simple because apparently no government is dealing with this drawback properly. The
fact is there is insufficient use of ICT in care and insufficient use of ICT in measurement of (health)
data. The necessary technology is already, available on the market and inside the laboratories.
Furthermore, we are not focussing on the issue of prevention of, for instance, the so-called society
diseases. Also, providing sufficient information to the public about health standards is a task which is
not covered satisfactorily.
For the future, Irina Odnoletkova suggested developing new models of care delivery and also
innovating changes to the financing system. Resources have to be redirected and new partnerships have
to be formed. All these basic innovations should lead to an overall disease management framework.
Jan Muehlfeit – Microsoft Europe
The heart beating inside Europe is a divided one: there is the healthcare and social heart on one side
and then there is also the economic / productive side. Thus split, the heart faces an ageing population,
an increasingly expanding part of the population with chronic diseases and a skilled labour shortage as
well as an increase in expectations of the citizens towards their governments concerning medicare and
healthcare. He also described the demographic situation as a ticking time bomb.
Microsoft wants to contribute to a shift away from reactive healthcare (which we are facing now)
towards proactive health and wellness. One concrete idea, for instance, was to provide joggers with
information about pollution in the cities. Another aim is to identify high risk populations in order to
provide targeted programmes. This can be achieved by using programmes or systems for fitness
management, which collect data about the health status of a person. Also, in order to lower the costs in
the healthcare system, incidents and the severity of illnesses have to be reduced.
The main barrier to adapting the healthcare system to the new (demographic) situation is that there is a
lack of government programmes in the area of ICT-based solutions supporting healthcare.
A major problem is also that, as yet, there are no connections between government, developers,
caregivers, etc. Sustainable business models need to be developed. Most of the technology which is
37
needed to carry out the first steps in improving healthcare, is already available. We only have to take it,
assemble it and adjust it to the particular specifications.
Henning Seiding – Odense Municipality, DK
Odense is the third largest city in DK and it is situated at the centre of the Island of Funen. It has
187.000 inhabitants.
The big challenges in the current situation are a decreasing labour force and an increasing number of
elderly people. Nowadays, clients are more demanding and, as a result, new technological opportunities
arise. At the same time, governments everywhere are practising a policy arguing that money is tight,
which leaves little space for innovations in a new and mostly undiscovered sector.
The vision of Odense is: “to create an International Centre of Excellence within welfare technologies
(development, implementation and dissemination of technologies in social and health care).” The
municipality also wants to focus on supporting innovations, in both the public and private sector. They
want to achieve financial growth and to advance the co-operation between public and private sectors as
well as co-operation across municipalities. Also, the municipality of Odense already has a strategic
action plan. From 2009 to 2012 the city council has agreed on a funding total of three million euros for
projects in the area of welfare technology. The entire region of southern Denmark will provide funding
to the amount of 7.5 million euros from 2010 to 2013. In Odense, a new Centre of Welfare
Technologies will be founded under the project name “Welfare Tech Region”. Future goals of Odense
will be establishing living labs which means involving end-users systematically in the development of
new technological solutions. Also, there needs to be a holistic view on welfare technologies which
means (among other things) that stronger national and international co-operation is necessary. The
public sector is going to be the future customer for well-being technologies.
Discussion
“What would you like to have done in order to remove barriers?”
One big barrier is financing and the other is acceptance among end-users but also many companies are
not aware of the changing situation, or from an economic point of view, of this market that is opening
up. However, it should be made clear that all this is not about technology but about finding solutions to
support and help people.
If you are developing a niche product, and that is what healthcare and welfare technologies have been
until now, especially in a small country, it is extremely hard to survive with your ideas and products.
With the market being very small, products are often tailor-made for a specific purpose and the support
from companies is poor.
Another major barrier lies in politics and the fact that politicians do not explain the challenge that the
generation gap will present to the voters. Currently, it is still of no political use to them because we do
not face or feel any serious effects on our daily lives. However, this lack of urgency has to be overcome
in politics before it is too late because the politicians can contribute massively in creating an awareness
38
of how urgent it is to make the change in direction. We already have visions and also some strategies so
now implementation measures also have to be taken. They can only be taken if there is (ideally)
support from the government and substantial support from industry. More political courage is the basic
need to improve the situation. For instance, could the current crises also be taken as an opportunity to
make some changes? Cuts will have to be made anyway. The governments should make them in the
right areas and re-direct money where it can save costs when the change in direction eventually
happens.
Experiences have to be shared and not bunkered. Companies and research institutions have to
cooperate and not be rivals. It should be clear that we are all working for and aiming towards the same
goal. Nevertheless, we have to be aware that almost every country has a different healthcare system and
different financing principles. We must not make the mistake of merely “copying and pasting” the
different solutions from country to country. That would be counterproductive. Every institution should
also develop suitable business models, relative to its country’s needs and preconditions.
We, who are working, researching and developing in this growing sector of AAL, have to continue to
build up networks where we can join forces, exchange experiences and work together on new solutions
to improve the quality of life for an ageing society, our society.
39
40
SESSIONS
41
42
AAL PROJECTS I
Iris Kaiser1, Claudia Oppenauer2
Chair of session: Silas Olsson, Central Management Unit of the AAL Association
Speakers:
1. Dimitrios Tzovaras, Informatics and Telematics Institute (ITI), Centre of Research and
Technology – Hellas (CERTH), GR and Jesús Salazar, Siemens, ES: Remote health and
social care for independent living of the isolated elderly with chronic conditions (REMOTE)
2. Paul J.M. Havinga, Pervasive Systems Research Group, University of Twente, NL: Inertial
Sensing System for Advanced Chronic Condition Monitoring and Risk Prevention (ISACTIVE)
3. Fiorella Marcellini, Research Department, INCRA (Italian Institute on Ageing), IT: A
home-based approach to the years of ageing (HAPPY AGEING)
4. Didier Stricker, German Research Center for Artificial Intelligence (DFKI) GmbH, DE:
Physical Activity Monitoring for Ageing People (PAMAP)
5. Wolfgang Zagler, fortec, Vienna University of Technology, AT: Domestic Robot for Elderly
Assistance (DOMEO)
6. Martin Litzenberger, Austrian Institute of Technology, AT: Safe Private Homes for Elderly
Persons (CARE)
In this session, six projects funded by the first call for proposals of the AAL Joint Programme, entitled
“ICT based solutions for Prevention and Management of Chronic Conditions of Elderly People”, are
presented.
1. Dimitrios Tzovaras presented the REMOTE project. Fifteen partners from eight countries are
involved and are investigating the needs of elderly people and the self-care and the self-management of
chronic conditions. REMOTE will prototype technology-based solutions well adapted to the respective
diagnosis, prevention and treatment opportunities that can be pursued while allowing the elderly to stay
“at home”. The homes of the elderly will be enhanced with audio-visual, sensor/motoric monitoring
and automation abilities to trace vital signs, activity, behaviour and health conditions, and to detect
risks and critical situations as well as to provide effective and efficient support at home, both
proactively and reactively.
1
2
Department of Neurosurgery, Medical University of Vienna, Austria.
Institute of Clinical, Biological and Differential Psychology, University of Vienna, Austria.
43
2. Paul Havinga introduced the IS-ACTIVE project. The project aims to promote and encourage
activity in older people with chronic conditions. Target groups are, in particular, patients with chronic
obstructive pulmonary disease (COPD) and their caregivers. Firstly, activities are monitored by a
wireless sensor system and evaluated. Finally, real-time feedback is given in order to stimulate and
enhance self-management of chronic disease.
3. Fiorella Marcellini presented the HAPPY AGEING project. The project partners come from seven
countries and different disciplines. The project aims to prevent the incidence of chronic illness and the
management of conditions supporting independent living. The target group are older people and their
caregivers where older people with mild physical impairment are motivated to live at home. In all
stages of the project, user-involvement is intended. The developed system will integrate sensors and
technologies available on the market in a whole smart system (RFID), able to assure reliability and the
privacy of the user. The system will be composed of three main modules: life style monitor, navigation
assistant and personal assistant.
4. Prof. Didier Stricker from the German Center of Artificial Intelligence presented the PAMAP
project. The abbreviation stands for “Physical Activity Monitoring for Ageing People”. The aim of the
PAMAP study is to increase motivation in the elderly towards physical exercise, as sufficient physical
activity is an important precondition for “healthy ageing”. In general, (elderly) people across Europe
are not active enough and overestimate their amount of physical activity. In the PAMAP project an onbody sensor network analyses musculoskeletal motion in order to compare actual and targeted physical
activity. The PAMAP system consists of a mobile platform and a home TV station. The information
collected with the system can be shared with family, friends and clinicians via the Internet.
5. Dr. Martin Litzenberger from the Austrian Institute of Technology (AIT) introduced the CARE
project. CARE is used as an acronym for “Safe private homes for elderly people”. The project aims to
develop and implement an intelligent optical tracking and alarm system for elderly end-users. The
system detects falls and informs on unusual behaviors (like not getting up in the morning) by means of
an optical sensor chip (CMOS). Another aim of the study is to integrate the system with an established
wireless home care system. As the system can be easily integrated into existing homes, it is not only
applicable for nursing homes but also for elderly people living alone. The CARE project is carried out
in cooperation with Finnish, Hungarian and German partners.
6. Prof. Wolfgang Zagler from the Technical University of Vienna presented the benchmark data of the
DOMEO project. DOMEO stands for “Domestic Robot for Elderly Assistance”. It is a threeyear project
with eight French, Austrian and Hungarian partners involved. The objective of the DOMEO project is
to evaluate two assistive robotic systems in different settings and applications. The RobuWalker
provides physical interaction with the user assisting the sit-to-stand and walking activities. Moreover,
the device can monitor the user’s heart rate and sends the reading to the processing centre. The
RobuMate is a communication device providing verbal and visual human robot interaction. It also
addresses cognition and memory, and supervises the user’s behaviour.
44
AAL PROJECTS II
Lukas Roedl1, Markus M. Morandell2, Michael Huch3
1. Introduction
This session is about projects funded under Call AAL-2008-1. The topic of the call is “ICT-based
solutions for the prevention and management of chronic conditions of elderly people”. It is stressed
that it is not about chronic illnesses or diseases, but focussed on elderly people with identified risk
factors and/or chronic conditions. The aim is to focus on the end-user and not on caregivers or
professionals.
In total 118 proposals were submitted, 56 were evaluated positively. In total 452 partners
collaborated in those projects (an average of 8 partners per project). The high percentage (39%) of
SMEs within the projects is remarkable.
2. “Home-based Empowered Living for Parkinson’s Disease Patients (HELP)” Mrs. Maria Elena Cruz Martin
Project Name
Coordinator
Duration
Involved Partners
Aim
Home-based Empowered Living for Parkinson’s
Disease Patients (HELP)
Luis Pablo del Arbol Perez, Telefonica
Investigacion y Desarrollo (ES)
06/2009 – 06/2012
7 partners, 3 countries
Hahn-Schickard-Gesellschaft für angewandte
Forschung e.V. (DE), Nevet Ltd (IL), Mobile
Solution Group GmbH (DE), SALIWELL Ltd
(IL), Telefonica Investigacion y Desarrollo
Sociedad Anonima Unipersonal (ES), Telecom
Italia S.p.A. (IT), University and Hospital of
Palermo (IT)
The objective of the HELP project is to develop
a comprehensive system able to administer drug
therapy in a controlled and either continuous or
on-demand basis, to manage disease progression
and to mitigate Parkinson’s disease (PD).
1 Austrian Institute of Technology, Health & Environment Department, Biomedical Systems (Wr. Neustadt, Austria).
2 Austrian Institute of Technology, Health & Environment Department, Biomedical Systems (Wr. Neustadt, Austria).
3
Central Management Unit of AAL Joint Programme, Germany.
45
Total funding:
Webpage
€ 2.5 million
-
The developed system consists of several parts:
•
A non-invasive, intra-oral, continuous anti-PD drug delivery device (for continuous drug
delivery),
•
A subcutaneous pump to deliver rescue medication in order to prevent PD blockade episodes
based on motor activity,
•
A PAN (Personal Area Network) to gather user’s environment information to detect
blockades,
•
A telecommunication and services infrastructure to analyse and transfer information both
from the user to an automated system ( majority of the time) or a point-of-care (for regular followup and emergencies) and in both directions,
•
A remote point-of-care unit to supervise the patients,
•
A base station is used to read the amount of delivered drugs and to transmit it to the care
professionals. This allows direct feedback and adjustment. This is also compared with the amount
of movement by the user with motion sensors. Thus, the effects of blockades can be prevented.
3. A technology pLatform for the Assisted living of Dementia elDerly
INdividuals and their carers (ALADDIN) - Maria Haritou
Project Name
Coordinator
Duration
Involved Partners
Aim
Total funding:
Webpage
A technology pLatform for the Assisted living
of Dementia elDerly INdividuals and their carers
(ALADDIN)
Maria Haritou, Institute of Communication and
Computer
Systems,
National
Technical
University of Athens, (GR)
27 months
8 partners, 6 countries
Aethia (IT), ATOS Origin (ES), Badalona
Serveis Assistencials (ES), Psychiatric Hospital
Of Attica (GR), Fraunhofer-Gesellschaft zur
Förderung der angewandten Forschung e.V.
(DE), Institute of Communication & Computer
Systems (EL), The National Hospital for
Neurology & Neurosurgery (UK), Universita di
Bologna (IT)
To utilise state-of-the-art in ICT in order to
develop an integrated solution for the selfmanagement of dementia, supporting both
patients and informal caregivers (by de-stressing
them) in this procedure
€ 1.4 million
-
The system consists of: data monitoring, a data repository, risk assessment, information
aggregation, social networking utilities, interfaces to existing systems like HER, HIS and security
46
features. It should allow an efficient patient follow-up and a timely detection of deteriorating
symptoms as well as an adaptive care/personalised intervention.
4. Hear Me Feel Me - Compensating for eyesight with mobile technology
(HMFM) – Dr. Minna Isomursu
Project Name
Coordinator
Duration
Involved Partners
Aim
Total funding:
Webpage
Hear Me Feel Me - Compensating for eyesight
with mobile technology (HMFM)
Minna Isomursu, Technical Research Centre of
Finland (FI)
24 months
8 partners, 3 countries
Fundación ROBOTIKER (ES), Organización
Nacional de Ciegos Españoles (ES), Nokia
Corporation (FI), ToP Tunniste Oy (FI), Caritas
Foundation (FI), Finnish Federation of the
Visually Impaired (FI), Oulun 6. Joutsen
apteekki (FI), National Center for Scientific
Research „Demokritos“ (GR)
The HMFM project explores services related to
medication and medicine-related information
and services, and to health monitoring and diet
information. Enabling technologies for the
services will be mobile devices and near-field
communication (NFC) technology.
€ 1.5 million
http://www.hearmefeelme.org/
The project goal is to improve the quality of life by providing a mobile service access for the
visually impaired elderly. To reach this goal, medication and medicine-related information and
services as well as health monitoring and diet information is used. Another goal is to support the
user by means of touching and hearing through mobile phones and digital service access through
NFC tags. So the concept of this project is to gather information from home medical equipment
(e.g. medical parameter levels), information about food and other information available through a
multimodal phone which supports a visual display, speech synthesis, audio input/output and
vibration. Another scenario is that the user can access his/her personal medication dosage and
additional information with the help of NFC tags which are attached to the medication packaging.
5. Development of a non-invasive CAPacitive sensor oral MOUSE interface for
the disabled elderly (CAP MOUSE) - Tomas Brusell
Project Name
Coordinator
Duration
Involved Partners
Development of a non-invasive CAPacitive
sensor oral MOUSE interface for the disabled
elderly (CAPMOUSE)
Tomas Brusell, Brusell Dental AS (NO)
4 partners, countries
HMC International NV (BE), Pensionärernas
47
Aim
Total funding:
Webpage
Riksorganisation (SE), Lots Design (SE), Stinct
(SE)
With a non-invasive modus operandi, CAP
MOUSE will use external capacitive sensors
mounted on a CAP MOUSE headset to scan
tongue movement and feed the signal into a
processing unit that extracts and translates
features from the signal into e.g. mouse clicks
and commands of the integrated Mobile Device,
thereby replacing the keyboard, the remote
control and other electronic devices.
€ 1.3 million
http://www.brusell-dental.com/aal
The project goal is to develop a patented technology for truly hands-free computing and remote
control. Therefore, the most flexible muscle in the human body – the tongue – is used in a noninvasive way to enable an “ultimate human interface” totally without medical risks. Basically a
standard headset is used and no parts of the device are inside the mouth. It’s also possible to
combine this technique with an additional “voice to screen” and numerous other interface
technologies. The device is already in the pretesting phase.
6. IT: Health @ Home - A Telecare System for Patients with Chronic Heart
Failure - Luca Fanucci
Project Name
Coordinator
Duration
Involved Partners
Aim
Total funding:
Webpage
Health@Home (H@H)
Luca Fanucci, Consorzio Pisa Ricerce (IT)
02/2009 – 02/2011
8 partners, 3 countries
Caen
Aurelia
Space
(IT),
Caribel
Programmazione Srl (IT), Centro Andaluz de
Innovación y Tecnologías de la Información y
las Comunicaciones (ES), Consorzio Pisa
Ricerche (IT), Fondazione Gabriele Monasterio
(IT),
Mediasoft
Ltd
(SI),
Hospitales
Universitarios „Virgen del Rocío“ (ES),
Zdravstveni dom Koper (SI)
The Health at Home project (H@H) aims at
solving societal problems related to the
provision of healthcare services for elderly
citizens affected by Chronic Heart Failure
(CHF).
€ 1.4 million
http://www.health-at-home.eu/
To date telemedicine is hardly “extensively” used by public health organisations. Chronic heart
failure is the most common cause of hospitalisation for Europeans 65+. Therefore, the aim is to
develop a tele-monitoring system that is included in the public health system. Thus, it is made
compatible with the “As.Ter Software Platform “that is used in 20% of the Italian public health
48
institutions. It is HL7-RIM and HL7-CDA compliant. The project is user (health care providers)
driven.
The system will apply a wearable sensor device for monitoring pathophysiological cardiovascular
and respiratory parameters and, at the same time, enable medical staff to monitor situations from a
distance and take action in where necessary.
7. User-Sensitive Home-based Systems for Successful Ageing in Networked
Society (AGNES) - John A. Waterworth
Project Name
Coordinator
Duration
Involved Partners
Aim
Total funding:
Webpage
User-Sensitive Home-based Systems for
Successful Ageing in Networked Society
(AGNES)
John Waterworth, Umeå University (SE)
36 months
9 partners, 7 countries
CanControls (DE), Research and Education
Laboratory in Information Technologies-Athens
Information Technology (GR), Graz University
of Technology (AT), Universidad Nacional de
Educación a Distancia (ES), ModernFamilies
(AT), KMOP (EL), Onda Communication
S.p.A. (IT), Fundacion Instituto Gerontologico
Matía (ES), Skellefteå Kommun (SE)
The vision is to provide a user-sensitive, ICTbased home environment that supports a personcentric
care
process
by
detecting,
communicating, and meaningfully responding to
the relevant states, situations, and activities of
the elderly person with regard to mild cognitive
impairment or dementia.
€ 2.6 million
-
The aim is to reduce isolation and loneliness by increased social interaction, sensitive emotional
support, more participation in shared activities, practical support for daily needs and enhanced
feelings of security. Thus elderly people should be able to extend their independent life in their own
home. Furthermore, the new possibilities of ICT in the cognitive well-being of the elderly should be
explored.
Agnes follows a “User-led innovation approach”. Thus, design options are kept open to allow users
active involvement in design and testing from the very beginning. The vision is a “secured social
network system for older people” with tangible user interaction around the retained skills of older
users. The system should allow an unobtrusive detection/communication of activities and states.
49
AAL JP PARTICIPATION RULES
Pekka Kahri1
1. Introduction
The AAL Joint Programme is a new type of R&D funding programme in Europe. It is based on
joining the activities of its partner states on the theme of Ambient Assisted Living which is
supported by a financial contribution of the EC through Article 169 of the Treaty. AAL Joint
Programme has some characteristics that make it different from other European initiatives that are
addressing the questions of demographic ageing: 1) AAL aims at launching R&D activities that
have a 2-3 year time to market; it tries to fill the gap between research activities and the market
introduction of new products, systems and services. 2) AAL emphasises the role of end-users and
especially older people as active participants in the projects. 3) AAL stresses the importance of
market analysis and business model development in the projects in order to boost the market
introduction of new products, services and systems that are being developed. The session focusses
on the participation rules of the AAL Joint Programme and the specific requirements of business
models and end-user involvement.
During the session, a MobiTed polling system was used to stimulate the discussion and to
understand the viewpoints of the audience and to learn about their professional backgrounds. The
audience totalled about 70 persons, about half of whom belonged to the research community – the
rest being split according to the pie chart below (Fig. 1):
1 Pekka Kahri is a Senior Technology Adviser at Tekes, which is the most important publicly funded expert
organisation for financing research, development and innovation in Finland. Tekes promotes a broad-based view on
innovation: besides funding technological breakthroughs, Tekes emphasises the significance of service-related, design,
business, and social innovations. Pekka Kahri is the Finnish NCP in AAL Joint Programme and has been a member of
the AAL Executive Board and the chairman of the AAL Contents Working Group 2008-2009.
50
Fig. 1: Professional background of session attendees
2. “Framework for Business Models in AAL” – Mr. Pekka Kahri
AAL Joint Programme aims at launching research, development and innovation activities that can
bring new products, solutions or service concepts to the market within about 2 to 3 years after the
project end. The close-to-market nature of the programme means that developing suitable business
models for the developed solutions must be an essential part of the projects.
Wikipedia defines business model as follows: “A business model is a framework for creating
economic, social, and/or other forms of value. The term business model is thus used for a broad
range of informal and formal descriptions to represent core aspects of a business, including purpose,
offerings, strategies, infrastructure, organisational structures, trading practices, and operational
processes and policies.”
Business model development should be approached in a systematic manner, utilising a suitable
conceptualisation framework and involving different actors of the value network (end-users,
financers, delivery partners, service providers, integrators). In the domain of AAL Joint
Programme, “business model development” is not to be interpreted as only relevant in activities
involving enterprises and business partners, but whenever the objective is to create economic, social
or other forms of value with new solutions. This means that in AAL Joint Programme, activities of
non-profit and public sector organisations must also include business model development aspects.
Using the MobiTed polling system, the audience was asked to give their opinion on the question:
“Where is the biggest challenge/obstacle for the success of Ambient Assisted Living?” The replies
revealed that technology was not seen as a big issue (the majority of researchers in the audience!).
Instead the challenges are in understanding the market and older people’s needs and how to
capitalise that market (economic and structural questions). Results are illustrated in Fig. 2:
51
Fig. 2: Question: Where is the biggest challenge/obstacle for the success of Ambient Assisted Living (Number of
votes)
3. “Framework for End-user Involvement in AAL” – Ms. Maja Arnestad2
End-user involvement is a mandatory and an essential part of all collaborative projects funded under
the AAL Joint Programme. When developing new solutions for older people, there are specific
challenges related to end-user involvement that need to be addressed:
Who are the different end-users needed in creating new solutions?
Who is the customer of the new solution?
How can the end-users express their wishes and needs, especially when new technology is
involved or when older people have decreased cognitive capabilities?
Who may act legitimately on an older person’s behalf, especially in health and care related
issues?
How can the innovation potential of end-users in general and older people in particular best
be harnessed?
How to create an innovation culture where the design of new solutions is done with and for
the older people?
How is the input from end-users collected, documented, analysed and used in the
development of new solutions?
To poll the prior experience of the audience about methodologies of end-user involvement, the
following question was asked, using the MobiTed polling system: “Which methods of end-user
involvement do you have prior experience in?” Results are illustrated in Fig. 3:
2 Maja Arnestad is the programme co-ordinator for the Norwegian programme IT Funk (ICT for the disabled), and she
is the AAL NCP in Norway.
52
Fig. 3: Question: Which methods of end-user involvement do you have prior experience? (Number of votes)
After the presentation and lively discussion about end-user involvement, a check question was
asked: “In which phase of the innovation chain is end-use involvement most important?” The
results revealed that the audience was listening closely to the message from the presenter (Figure 4)
Fig. 4: Question: In which phase of the innovation chain, end-use involvement is most important? (Number of
votes)
53
4. “AAL rules for participation, eligibility and evaluation criteria” Dr Gerda Geyer3
The core of the AAL Joint Programme is to provide innovative Information and Communication
Technologies (ICT) based solutions to older people, which means innovative products, systems or
services addressing identified wishes and the needs of the end-users. Projects funded under the
AAL Joint Programme will be multinational, collaborative and cost-shared. Funding contracts of
individual project partners will be concluded with the national funding authority. The presentation
addresses the requirements for the AAL projects:
Characteristics of the collaborative projects
Eligibility criteria
Evaluation criteria
After the presentation and some detailed questions, the audience was asked to give their opinion on
the future thematic direction of the AAL Joint Programme (Fig 5).
Fig. 5: Question: In Which thematic area should AAL Joint Programme focus most in its future calls? (Number
of votes)
3 Gerda Geyer is the programme co-ordinator for the Austrian programme benefit, and she is the AAL NCP in Austria
and acted as the vice-chair of the AAL Contents Working Group 2008-2009.
54
HEALTHY AGEING
Uli Waibel1
1. Introduction
The ageing population poses a great challenge to Europe’s economic and social development. As
people are living longer, it is of paramount importance that costs for medical and social care will
not explode and that individuals can enjoy their lives in good health for as long as possible.
Healthy Ageing is one of the keys to a good quality, independent life – and thus it can also be seen
as an important foundation for Active Ageing.
What exactly do we mean by Healthy Ageing? Despite the fact that there is no “official” definition,
most characterisations of Healthy Ageing centre on the same ideas such as: “Healthy ageing
describes the ongoing activities and behaviours one undertakes to reduce the risk of illness and
disease and to increase one’s physical, emotional and mental health. It also means combating illness
and disease with some basic lifestyle realignment that can result in a faster and more enduring
recovery.”2
A closer look reveals a number of topics,3 amongst others in Healthy Ageing, to be addressed:
• Retirement and pre-retirement,
• Mental health,
• Nutrition,
• Physical activity,
• Injury prevention.
But Healthy Ageing not only represents challenges to society and individuals – it also offers
opportunities for economic growth based on new technologies, products and services.
Challenges and opportunities in Healthy Ageing are addressed and discussed within this session.
2. “Health and functional capability of older adults” - Dr. Harriet Finne-Soveri
Dr. Finne-Soveri is a geriatrician and consultant who graduated from the University of Helsinki,
1
Uli Waibel is managing director of Innovendo, a consulting firm specialized on marketing support for technology
based innovations. For several years Innovendo has been carrying out investigations and studies in the field of Ambient
Assisted Living and has supported the development of the Austrian AAL programme benefit.
2 http://www.seniors.gov.au/internet/seniors/publishing.nsf/Content/Healthy+ageing
3 Healthy Ageing project (2004–2007) - co-funded by the European Commission.
55
Finland in 1980. She became board-certified in geriatric medicine in 1994. She has been involved
in research and publications in the field of geriatrics since 1982.
At present, she is responsible for the Ageing and Services unit at the National Institute for Health
and Welfare which works to promote the well-being and health of the population, prevent diseases
and social problems, and develop social and health services. Prior to that, Dr. Finne-Soveri was
chief medical officer and managing director in the largest nursing home in Helsinki. She also is
adjunct professor in geriatric Medicine at the University of Helsinki.
In her talk, Dr. Finne-Soveri addressed the session’s topic by looking at the functional capacity of
the older individual and deriving guidelines for Healthy Ageing that can serve as entry points for
AAL products and services.
In essence, biological ageing leads to loss of functioning cells, increasing body fat, dehydration,
slowing down/stiffening and - very important - ageing of the regulatory/feedback mechanisms. This
decline in functional capacity in turn leads to more diseases in higher age and loss of social
connections. To keep functional capacity high, four main areas should be addressed:
• Nutrition: not losing weight in old age, balanced food (vitamin D, calcium, proteins);
• Motion, exercise, sport - no matter the disease MOVE (it’s never too late!)
• Mental/intellectual activities need to be trained (strong scientific evidence that disability and loss
of independence in old age is caused by loss of cognitive/mental capacity);
• Active social life maintains intelligence - makes life worth living.
Other areas to be addressed in order to keep up functional capacities - and to delay the need for care
- include amongst others vision/hearing, falls (fear of falling), depression and pain.
3. “Answering the challenges of demographic change in the field of cure and
care” - Dr. Guus Broos
Dr. Guus Broos studied sociology at Leiden University and received his doctorate from Radboud
University (Nijmegen). Currently he is director of the consulting firm Strategicon which delivers
medical provisions, technology and services to the semi-public sector.
Previously Dr. Broos was a member of the executive board of the Orbis medical and healthcare
group in Sittard Geleen, the Netherlands (from 2002). Orbis is a public chain care provider and
operates the Orbis Medical Centre, care centres, nursing homes, home care and mental healthcare
with a staff of approximately 6,000. Amongst others, Dr. Broos is Chairman of the Dutch
Association of Hospital Directors and a member of the advisory board of the Ambient Assisting
Living Association.
Dr. Broos approached Healthy Ageing from a societal and structural viewpoint. In the ageing
society, a paradigm shift is needed towards a structural change in the way health care is provided.
Without alternative models of social infrastructure and a model for health services, the pressure on
medical and care hospitals will be very high.
The lives of older people should be organised and thought of in a new manner, not the house/home
alone (smart home approach) but as an integrated community approach which includes housing,
services and infrastructure, on which providers can build innovative products and services that
56
people want to buy and use. New services should include areas such as social interaction, leisure
activities, wellness, prevention, guidance, monitoring status and behaviour, and social and medical
care.
A holistic approach is needed to achieve social participation and to keep costs for medical care
under control. Cooperation, innovation models and living labs are needed for different phases of
development, investment and realisation of new integrated living concepts.
4. “Technology and innovation challenges for ambient- assisted living” Dr. Péter Hanák
Dr. Péter Hanák has been employed by the Budapest University of Technology and Economics
(BME) since 1969. Between 1997 and 2006 he was employed by the Hungarian National Office for
Research and Technology (NKTH) where he was responsible for national calls for R&D proposals
in ICT, and represented Hungary in various committees established by the European Commission.
Currently, Dr. Hanák is a research fellow at the Dept. of Control Engineering and Information
Technology at BME and director of BME's Biomedical Engineering Knowledge Centre. He has
been involved in the national Hungarian AAL programme eVITA from the start. Dr. Hanák is also
the delegate of Hungary in the General Assembly of the Ambient Assisted Living Joint Programme.
Dr. Hanák completed the session by focussing on technology options and challenges in Healthy
Ageing. Many technological topics had already been addressed during the course of the conference
– an indication that the technical challenges to be solved in AAL are indeed difficult: long
unmanned operation, power consumption/battery power supply, reliable wireless connectivity,
interoperability and vendor independence, plug-and-play devices, seamless indoor/outdoor usage,
simplicity of user interfaces, wearable/environmental sensors – to name a few. While much effort
has been put into these areas in the past few years, relatively little has been achieved in practice.
On the other hand, the real strength of ICT lies in the opportunity to combine and analyse data from
various sources. As an example, the possible influence of temperature, humidity and a peaceful
night’s sleep on blood pressure or mental freshness is mentioned. ICT is also strong in collecting
and storing data over long periods of time: significant but not obvious changes in one's health status
can be detected and signalled by continuous analysis of such data.
The gender issue in old age seems to have been overlooked by technology developers – an area that
will need broader attention in the future.
5. Discussion and feed back
Using the MobiTed polling system helped to stimulate the discussion, understand the viewpoints of
the audience and learn more about their professional background: a majority of 55% of the
audience belonged to the research community – the rest being split according to the pie chart below
(Fig. 1):
57
Fig. 1: Professional background of session attendees
The biggest needs in Healthy Ageing for AAL support were seen in mental health and physical
activity, whereas the biggest opportunity for AAL support was seen in the area of physical activity
– as the diagrams below illustrate (Fig. 2):
Fig. 2: Biggest needs (left) and biggest opportunities (right) for AAL-support in Healthy Ageing (numbers of
votes)
Nutrician is still a key element in Healthy Ageing according to Dr. Finne-Sovery and will need to
be given attention.
In the discussion it was also argued that private homes are the main focus for groups of elderly
people (the so called third age) and represent a main market for AAL - when independence and
special care services are not yet needed.
The question asking for the biggest challenges in AAL for Healthy Ageing did not reveal anything
of surprise. Technology was not seen as a big issue (the majority of researchers in the audience!) –
the rest being more or less evenly spread among the available options – as illustrated in Fig. 3:
58
Fig. 3: Biggest challenges for AAL support in Healthy Ageing (numbers of votes)
59
ACTIVE AGEING
Antonio Mendes dos Santos1
1. Rationale for the session2
We live in an information society. Information and communication technologies (ICT) permeate
almost every aspect of our lives. They can be powerful tools for bringing people together, adding
new value to life and creating new wealth, health and welfare, and accounting for a richer and more
rewarding professional and social life.
The other side of the coin is that in Europe (and elsewhere) millions of people cannot fully reap
these benefits and a significant percentage is effectively cut off from them for a variety of reasons:
geographic, social, economic, educational, cultural, physical or cognitive disabilities, age, etc.
Today, older people are estimated3 to make up almost 20% of the European population or 90
million people. Furthermore, the prevalence of both disabilities and other minor functional
limitations is strongly related to age. The ongoing demographic shift in Europe, as a result of a
greater life expectancy and decreasing birth rates, will cause a noticeable increase in these numbers
over the coming years - 18% of the European population was aged over 60 in 1990, while for 2030
that percentage is expected to rise to 30%.
There are concerns that the European social model will be unsustainable with too few people of
working age who are able to support the welfare and social security systems providing for older
people. The renewed Lisbon Strategy calls for an extension of working life.
Additionally, a US-based study4 found that 60% of working-age adults, aged between 18 and 64,
are likely or very likely to benefit from the use of accessible technology due to mild difficulties and
impairments, or to functional difficulties with current technologies.
The audience had at their disposal an interactive polling system which allowed the Chair to put
forward questions and have real-time replies.
1
UMIC -- The Knowledge Society Agency, Ministry of Science, Technology and Higher Education, Portugal.
2 Adapted from the European Commission Staff Working Paper “Extended Impact Assessment of the Commission
Communication on eAccessibility” (Brussels, Sept/2005).
3 United Nations World Population Prospects (2002) and Eurostat 2004 Demographic Projections. See also
SENIORWATCH project reports (http://www.seniorwatch.de).
4 “The Wide Range of Abilities and Its Impact on Computer Technology” – Forrester Research Inc. 2003; study
commissioned by Microsoft Corporation, available at http://www.microsoft.com/enable/research/phase1.aspx.
60
There were 48 people in the audience at the start of the session, increasing to about 60 by midsession. The background of the initial audience was as follows:
2. “Active Ageing –
- Dr. Heidrun Mollenkopf
The
Various
Needs
of
Older
People”
“Active Ageing” is a term and concept used in many ways in public and scientific debates and
programmes. The presentation started with the question “What does ‘Active Ageing’ mean in older
people’s everyday lives?”, showing the significance of being able to pursue desired activities for
their quality of life.
The next issue addressed by Dr. Mollenkopf was “How far new ICT and AAL technologies and
related services have the potential to support older people in active ageing”. The speaker concluded
by highlighting the preconditions needed for a fruitful implementation and application of the
technologies, systems and services in order to meet older people’s various needs and wishes.
Speaker’s short CV
Dr. Heidrun Mollenkopf is a sociologist and gerontologist. She was Senior Researcher at the
German Centre for Research on Ageing (DZFA) at the University of Heidelberg until December
2004. Her main research focusses on the interplay among personal, societal, technical, and
environmental conditions with regard to maintaining autonomy and social participation, and hence,
the quality of life in old age. She has pursued this interest in several large-scale research projects on
technology and ageing, and on the outdoor mobility of older people, initially at the University of
Mannheim and then at the Social Science Research Center Berlin (WZB) and the Free University of
Berlin, and finally at the former DZFA.
Amongst others, she coordinated the EU-funded project “MOBILATE – Enhancing Mobility in
Later Life” and was in charge of the social sciences sub-project of the interdisciplinary research
project “sentha” (Everyday Technologies for Senior Households), funded by the German Research
Foundation (Deutsche Forschungsgemeinschaft) at the Technical University of Berlin. She has
published widely in the fields of ageing and technology, mobility, senior friendly neighbourhoods
61
and quality of life of older people. In addition, Dr. Mollenkopf served as a consultant and evaluator
in several European initiatives and programmes.
Since 2007, she has been a member of the BAGSO (The German National Association of Senior
Citizens Organisations) Board of Experts, of the VDE Ambient Assisted Living Innovation
Partnership (IpAAL) and Chair of the “Universal Accessibility and Independent Living” Expert
Group of AGE - The European Older People's Platform.
Kick starting the discussion:
Before the presentation started, the audience was asked the question “What do you understand by
‘active ageing’?”, the results of which were presented after the speaker finished:
3. “Enhancing User Experience of Older Adults” - Ms. Anna E. Pohlmeyer
Older adults, when given the chance, report more than just usability-related aspects of interactive
products. In laboratory settings, older adults are often confronted with unfamiliar technology. In
this case, instrumental qualities are of primary concern. However, the picture might be different,
when it is up to the participant to choose the device.
The presentation addressed a recently conducted ethnographic study: results demonstrate the
diversity of technology acceptance criteria. These surpass mere usability-related aspects and can be
better summarised as dimensions of user experience. The findings should be taken into account
when designing interactive products for older adults. Despite the prospect that technology can
enable prolonged independent living and active ageing, this will only hold true if older adults
accept the provided technology and feel motivated to use it.
Ms. Pohlmeyer concluded by stating the importance of user-centred design in the realm of
gerontechnology.
Speaker’s short CV:
Ms. Anna Pohlmeyer has an educational background in psychology from the University of Freiburg
and the Humboldt University Berlin (with distinction). She enhanced her studies with an emphasis
on cognitive psychology from an interdisciplinary perspective, including industrial design and
engineering.
62
Ms. Pohlmeyer’s research focusses on ageing, having started during collaborations with industry
(Daimler, Siemens) and continued at the Center for Lifespan Psychology, Max-Planck-Institute for
Human Development in 2005. In 2006, she joined the MIT AgeLab, working on ideas and
technologies to improve the quality of life of older adults.
Following a short-term teaching position for interaction design at the School of Art and Design
Berlin-Weissensee, Ms. Pohlmeyer is currently affiliated to the University of Luxembourg and the
TU Berlin as a research scientist of the Engineering Design Group.
Ms. Pohlmeyer’s areas of expertise are: ‘user-centred design’, ‘intuitive use of user interfaces’, as
well as ‘ageing and user experience’.
Kick starting the discussion
Before the presentation started, the audience was asked the question “When you need to use a new
device or technology, what is most important to you?” the results of which were presented after the
speaker finished:
4. Active Ageing: The perspective of working life and intergenerational relations
- Dr George W Leeson
As populations across the world continue to age well into the 21st century, societies are presented
with a number of challenges and opportunities. With the prospect of significantly more people aged
over 60 than under 15, societal and institutional infrastructures will have to respond to the needs
(and demands) of a mature society. This is true in the workplace, where the retention, recruitment
and re-training of mature workers will be key to securing workforces, and it is also true in the
community and the family where the contribution of individuals in later life is key to future
development.
63
From the Global Ageing Survey (GLAS) in Oxford, a new concept of later life in the 21st century is
emerging, and it is one of responsibility and contribution (in the workplace, the community and the
family).
This presentation linked the needs and demands of people in later life in the 21st century – as
evidenced by GLAS – with the desire and need for skills sets which will enable them to contribute
and age actively.
Speaker’s short CV:
Dr George W Leeson is Deputy Director of the Oxford Institute of Ageing and a Senior Research
Fellow in the Department of Sociology at the University of Oxford. Dr Leeson’s main research
interests are in the socio-demographic aspects of ageing populations, covering both the
demographic modelling of population development and the analysis of national and international
data sets.
Since 1985, Dr Leeson has directed the Danish Longitudinal Future Study, which elucidates the
attitudes and aspirations of future generations of older people in Denmark, and he is responsible for
the Institute for the Global Ageing Survey carried out in three waves in more than 20 countries in
Europe, North and South America and Asia and involving approximately 45,000 people aged 40-79
years.
Dr Leeson’s other research includes the demographic inequalities of global ageing, the changing
populations of Europe, migration and migrants in Europe, health and social elder-care migrant
workers, older people and homelessness in Denmark, family care in Denmark, life-long learning,
age discrimination, and working in later life and retirement.
Kick starting the discussion
Before the presentation started, the audience was asked the question “How much is the difference
between your initial (when you started to work) expected retirement age and the current expected
retirement age?” the results of which were presented after the speaker finished:
64
LABOUR-SAVING INNOVATIONS: CONTRIBUTIONS
FROM THE UK, DENMARK AND THE NETHERLANDS
Barbara van der Linden1,
Jane Hendy2,
Nanna Skovgaard3,
Claus F. Nielsen4
Introduction
Across Europe, projections have demonstrated the increasing number of elderly people in the next
decades. Since at least 2005, all demographic studies show a shift in population towards more
citizens aged 65 and above, and within that group in particular, higher numbers of frail elderly
people over 80 in all European countries by at least 2040. The rate and extensiveness of the
demographic shift differs between countries, but the overall trend has been recognised across
Europe as a whole.
Numerous research and policy papers indicate that if health care systems are faced with meeting the
care needs of this rising elderly population, the pressure on the health care labour force will
increase dramatically. In the Netherlands, it is estimated that if the health care system continues
working as it does today, there will be a demand for 470.000 more health care workers by the year
2025.
The flipside of this demographic shift is that the proportion of younger potential care givers is
decreasing and the feasibility of being able to recruit sufficient numbers of new care givers and of
being able to finance them is not perceived as realistic. Besides increasing efforts to find, train and
employ new care givers, policy must then also be directed towards a better utilisation of existing
personnel. In the UK, Denmark and the Netherlands, several programmes are directed towards
finding, developing and testing labour-saving innovations that can be implemented to address this
growing need. This article discusses labour-saving initiatives in these three countries and presents
steps that must be taken to ensure that care of an acceptable quality is available for elderly people in
the next decades.
1 Barbara van der Linden, ZonMw, NL.
2 Jane Hendy, Imperial College Business School, UK.
3 Nanna Skovgaard, Agency for Governmental Management, Ministry of Finance, DK.
4 Claus F. Nielsen, DELTA Business Development, DK.
65
Overview of the current investment in 3 countries
The need for labour-saving innovations has been recognised in the UK, Denmark and the
Netherlands and programmes have been initiated in each of these countries.
UK:
In the UK over 20 government reports since 1998 have called for telecare. The UK has backed this
policy drive with financing. Approximately £177 million has been allocated by the government to
health and social care services to introduce remote care into around 180,000 homes during 2006 –
2011 (via the Preventative Technologies Grant in England and equivalent schemes in Scotland and
Wales). This activity has been further supported by one of largest government sponsored,
randomised, controlled trials of telecare. Called the “Whole System Demonstrator programme”, the
trial involves a combination of remote-care systems and redesigned service delivery models that are
being implemented in 6,000 homes at a cost of approximately £50 million (Department of Health,
2007). The total resident population covered is at least one million and covers a variety of chronic
conditions and care needs.
Denmark:
The Danish government has allocated approximately 400 million euro to a dedicated programme
(2009 to 2015) directed towards developing and improving public sector services through the
implementation of labour-saving technologies and more efficient working processes. The
programme spans all public sector activities and a range of projects are currently being funded
across different thematic areas including “Telecommunications Solutions and Information and
Communication Technology (ICT)”, “Robotics and Automation”, “Digitalisation” and “Care
Technology”.
The programme aims to increase productivity and efficiency in the public sector and to improve
current working conditions of public employees, thus making jobs in the public sector more
attractive to a shrinking labour force. In addition, the objective is to provide the choice of more
flexible, user-centred services to citizens, empowering them to remain independent for as long as
possible and to take responsibility for their own lives.
Across the entire public sector, public authorities can apply for project funding, either alone or in
collaboration with private companies. This is in order to stimulate growth in Danish trade and
industry. There are two types of projects:
• Local demonstration projects where new labour-saving technologies and organisational
models are tested in pilot settings;
• National implementation projects where well-proven technologies and practices are
implemented on a national scale;
Applicants should be able to profit from the main part of the labour-saving potential, service and
production improvements themselves, but the programme also stimulates implementation nationally
when a project has proved to be a positive business case/benefit realisation.
66
The Netherlands:
In 2006 the national health care research and innovation institute ZonMw held a survey which
yielded 200 labour-saving ‘ideas’. From 2007 to 2009, an innovation programme was run in longterm care (15 million euro) with three distinct sub programmes:
1.
In order to increase the evidence on which interventions can actually save care givers time,
two new measuring instruments were developed. A tool for determining the labour-saving potential
and the actual labour-saving effects of new interventions was developed, tested and made freely
available online for use by health care organisations (see website, currently only available in
Dutch; an English translation is currently being planned). Another tool was developed for a more
in-depth analysis of cost-benefit ratios for creating business cases of promising new interventions.
2.
These tools were applied to the ideas that had emerged from the 2006 survey and in 110
projects that were commissioned through a call for new ideas.
3.
57 successful labour-saving interventions were guided towards communication and
implementation activities through a website, breakthrough series and inclusion in practice
guidelines.
Lessons learned from labour-saving investments
The UK initiatives have resulted in thousands of pilots mainly in remote care innovations which
show the huge labour and cost saving gains to be made by more widespread implementation.
However, because telecare can be seen as a service-delivery innovation supported by new
technology, and given the complexity of the care system, it is difficult to evaluate telecare using
conventional approaches. The small-scale and often shorter term nature of telecare trials also means
that rigorous evidence about the longer term impact of many types of telecare remains elusive. To
investigate long-term systemic outcomes, there is a need for simulation modelling. This is
recognised as an appropriate technique for exploring the long-term effectiveness of telecare on
resources and is used as a tool to improve the basis for decision-making (Bayer, Barlow & Curry
2007).
The Danish programme is still in an operational phase and is currently too preliminary to
demonstrate proven effects. A range of projects is currently being supported across the different
thematic areas. Within the theme “Care Technologies,” projects, for example, test and deploy agefriendly toilets, electronic bath/shower chairs, electronic tools supporting people with autism,
alarm/tracking systems for people with dementia, medication reminders for people with mental
disorders, electronic tools for self-activation of retarded adults, solutions for lifting/moving frail
older people, electronic door locking systems and fall management.
The focus placed on service delivery by health care institutions as well as limited capacity and
resources to make investments have been identified as barriers to innovation by the Danish
initiators.
The establishment of a dedicated programme on a national level that gathers the best new ideas and
projects, funds them, evaluates them and communicates key learning points to all involved partners
has great potential. This programme should coordinate and help facilitate the sharing of knowledge
between different initiatives (e.g. in different parts of the public sector) in order to generate synergy
effects and reap benefits on a larger scale.
67
Access to the right decision-making arenas and budget negotiations on a national level is a key to
success. Denmark is a very decentralised country when it comes to providing welfare. Every year,
the government (via the Ministry of Finance) engages in budget negotiations with the
municipalities and the regions (the latter of which are responsible for the health care sector). In this
way, by linking budgets with the use of new technologies and more efficient ways of working, the
state will be able to steer the development of the public sector in a clear direction.
Both UK and Danish experiences indicate a currently existing lack of evidence and convincing
business models which can, in part, explain a perceived lack of sense of urgency in these countries
to upscale labour-saving interventions.
The Dutch programme yielded evidence on the labour-saving effects of reorganising basic work
processes in health care organisations such as bathing, eating, transferring, and medication
dispensing. Some projects showed labour-saving results in reorganising back office logistics
through the introduction of electronic records, planning or routing systems for personnel and
patients as well as in education and a reduction in sick leave. In addition, self management by
patients results in positive labour-saving effects through the use of telecare and e-health
technologies and simple domotics. The projects showed savings ranging from €7 to €16.000 per
patient per year. An extrapolation was made to determine relevant target groups nationwide. They
ranged from 2,100 to 500,000 patients for respective interventions nationwide. ZonMw concludes
tentatively that millions of euro and thousands of personnel FTEs can be saved without quality loss
and without, as yet, introducing high-tech solutions.
Necessary next steps
The experiences gained by these three countries’ labour-saving initiatives are similar. Evidence on
actual labour and financial savings by the introduction of a wide range of types of high and low
tech interventions is promising, but not yet robust. The Dutch programme has yielded user friendly
measuring instruments which, through a more widespread application, could build on a larger
knowledge base. Work is currently being done on producing an English translation to enable use of
the instruments by a wider community. As yet, tests are being run to determine the applicability of
these instruments in commissioned AAL projects and the support necessary to use them.
Application in the AAL programme could help to build a database of evidence-based, labour-saving
interventions which would promote further knowledge dissemination and implementation. More
extensive use of simulation modelling and extrapolation techniques could further build on evidence
of cost effectiveness without requiring the time that is most often needed for actual experimentation
in service practice. Demonstration projects, however, can also be commissioned to show real world
attainability of results.
The next step is to use the gained evidence to create more convincing business cases. These will
encourage decision makers to invest in labour-saving innovations. In each country, however, the
need for active implementation trajectories has been indicated. Financing and/or co-financing
through government programming is deemed necessary in a context where urgency is not (yet) felt
to address looming personnel shortages and decreasing availability and quality of care that will
inevitably occur across Europe as a result.
68
References
UK:
Implementing telecare. Evidence from the UK, pdf. Presentation Jane Hendy AAL-Forum Vienna,
October 2009.
Department of Health (2007). White Paper pilots. Whole system long-term conditions (LTC)
demonstrator
programme.
www.dh.gov.uk/en/Healthcare/Longtermconditions/DH_4140328
(accessed 22.06.2008).
Steffen Bayer, James Barlow, Richard Curry, 2007, “Assessing the impact of a care innovation:
telecare”, System Dynamics Review, 23(1): 61-80.
Denmark:
Danish Initiatives on Labour-Saving Technology, pdf. Presentation Claus Nielsen and Nanna
Skovgaard, AAL-Forum Vienna, October 2009.
Programme web site: http://www.abtfonden.dk/
Website for the Danish
http://oes.dk/sw353.asp
Agency
for
Governmental
Management
(in
English):
The Netherlands:
Labour-saving innovations in long-term care lessons from the Netherlands, pdf. Presentation
Barbara van der Linden, AAL-Forum Vienna, October 2009.
Zorg voor mensen, mensen voor de zorg. Arbeidsmarktbeleid voor de zorgsector richting 2025.
Advies van het Zorginnovatieplatform, november 2009.
Programme website: www.zorgvoorbeter.nl.
Website Netherlands Institute for Health Research and Development ZonMw: www.zonmw.nl.
69
PROGRAMME benefit: LAUNCH OF THE FIFTH CALL
FOR PROPOSALS
Gerda Geyer1
The Session was designed to give insight into the genesis, the implementation and the thematic
background of Programme benefit and its focus “ICT-based Solutions for Advancement of Active
Ageing”. Various aspects of the living situation of older people in Austria and other European
countries were outlined on the basis of the SHARE project. Project examples illustrated the
different thematic clusters within the focus of the call.
The Ambient Assisted Living Joint Programme is a common funding activity by 23 European and
associated States. Some countries also fund national programmes in the thematic field of AAL, as
Austria does with the R&D funding Programme benefit. The Programme benefit is owned by the
Austrian Federal Ministry for Transport, Innovation and Technology (BMVIT). In her introductory
presentation, Kerstin Zimmermann (BMVIT) gave a brief insight into the strategic interplay
between the Ambient Assisted Living Joint Programme and the national counterpart Programme
benefit which focusses on the thematic field of AAL as well.
Kerstin Zimmermann highlighted the fact that in Austria 80% of care is based in the families and
that 80% of carers are women with an average age of 56 years. The value of these services amounts
to approximately 2-3 billion euros per year. She also stated that implementing new technologies
into society is extremely challenging because social, political and economic systems change
linearly whereas technological change is exponential.
Georg Niklfeld from the Austrian Research Promotion Agency (FFG) gave some explanations
about thematic funding in the FFG. The Austrian Research Promotion Agency (FFG) is the national
funding agency for industrial research and development in Austria. As a "one-stop shop" offering a
diversified and targeted programme portfolio, the FFG gives Austrian businesses and research
facilities quick and uncomplicated access to research funding.
The FFG was founded on 1st September 2004. The FFG is wholly owned by the Republic of
Austria, represented by the Federal Ministry for Transport, Innovation and Technology (bmvit) and
the Federal Ministry of Economics and Labour (BMWA). As a provider of funding services,
however, the FFG also works for other national and international institutions.
1
Dr. Gerda Geyer, Austrian Research Promotion Agency, programme manager of Programme benefit and National
Contact Point for the Austrian participation in the AAL JP.
70
The thematic funding programmes managed by the FFG focus on strategic priorities for Austria’s
research landscape and thereby promote research activities in promising fields concerning socioeconomical and technical needs. The range of available funding types is geared towards forming
critical masses in specific thematic fields by increasing cooperation at an early stage between the
business and science sectors to improve international visibility.
In 2008, the department of “Thematic Programmes” within the Austrian Research Promotion
Agency comprised 12 R&D funding programmes. The funding budget amounted to 190 million
euros. In total, 1,106 proposals were submitted. 533 new contracts for funded projects were
established.
From the funding perspective, the session then made a shift towards a deeper understanding of the
primary end-users group of AAL/benefit proposals. Isabella Buber-Ennser from the Vienna
Institute of Demography discussed “The Living Situation of Older People in Austria compared to
other European Countries”. The presentation was based on the “Survey of Health, Ageing and
Retirement in Europe” (SHARE), a European dataset that includes accurate cross-national
information on economic circumstances, health and well-being, integration into family and social
networks. Living conditions of older people in Austria were compared to other European Countries,
including family status, children and housing. Diverse financial indicators like income, net worth,
house ownership as well as the subjective assessment of the economic situation of the household
were presented for Austria and for the other 10 European countries included in SHARE. Another
main aspect of ageing is health and the presentation focussed on dimensions like self perceived
health, diagnosed chronic conditions, limitations in the “Activities of Daily Living” (ADL) as well
as in “Instrumental Activities of Daily Living” (IADL). Finally, the social network of the
population aged 50 years and over was discussed, including children and the geographic distance to
children, social engagement such as participation in voluntary work as well as given and received
help.
From the end-users perspective, the session returned to the funding possibilities of programme
benefit. Gerda Geyer from the Austrian Research Promotion Agency (FFG) presented “The Fifth
Call for Proposals” launched in the programme benefit.
The presentation gave basic information on the focus and the objectives of the Fifth Call for
Proposals, the proposal requirements and the practicalities of proposal submission.
Similar to the WHO definition of active ageing, the Austrian programme benefit defines active
ageing as a process which enhances the quality of life of the individual by reaching the maximum
access to participation / social integration, security and health.
An overview on the thematic focus of projects funded in 2008 was given according to the thematic
clusters included in the focus on active ageing. Funded projects covered the following thematic
areas:
Cluster 1: Social inclusion
• Communication terminal; touch screen interface
• Interactive, user-oriented and user-driven web portal
• Multimedia communication system for people who live alone
71
Cluster 2: Activities
• Strength-based training system for home usage
• Unassisted control of balance risk of falls and activity levels, exercise programme
Cluster 3: Comfort and security
• Vital monitoring, contextualised personalisation and support
• Reliable and automated computer vision system, robust fall detection
Programme benefit: Types of Projects Funded in 2008
Cooperative Projects
Human Resources Projects
Stimulation Projects / Studies
Stimulation Projects / Workshops
Concept initiative
7
2
7
3
1
Source: FFG, 2009
In order to gain a deeper understanding of what projects in the Programme benefit are about, two
examples of funded R&D projects were presented at the end of the session.
Scientist Brigitte Krenn (ÖFAI & Scientific Consultant to Research Studios Austria) presented the
project VITASMART which was funded under the third call for proposals of the Programme
benefit (2008) in the Thematic Cluster 3: Comfort and Security.
The chief goal of VitaSmart is the development of SmartyVital, a smart home companion
performing the monitoring of vital functions. SmartyVital is based upon the prototype of BEKO’s
Smart Home Centre and provides contextual personalisation and situation-driven support of
end-users of smart homes with regard to monitoring vital functions. The project defines the
monitoring of vital functions as the ability of a system to identify and qualify changes in the daily
routines of the smart home user and react appropriately, for example, by activating emergency
assistance systems. Existing systems currently offered by emergency assistance organisations rely
on periodical confirmation by the user which is given by pressing a button within a specified time
window. Such systems suffer from an enormous error rate, mostly due to the smart home users’
forgetfulness, so that in most cases such services are unsubscribed after a short time or not offered
at all due to cost considerations. The smart home companion, which is to be developed in the
project VitaSmart, is a contribution to the alleviation of these shortcomings.
The aspect of VitaSmart that makes it unique is the 24/7 real life data obtained from smart home
installations used and tested by friendly customers. These data are used in the development process
of SmartyVital. The consortium expects SmartyVital to raise the quality of life for the assisted
individuals and thereby create considerable public benefit in the long run.
The second project was presented by Christian Menard from FH Technikum Kärnten. The Project
Health@Home has been funded under the third call for proposals in Programme benefit (2008) as
well as in the thematic cluster: Activities.
Due to a number of epidemiological studies over the last few years, it is well established that
structured, regular training is one of the most important pillars, if not the most important, for the
72
prevention and rehabilitation of society’s number one disease – the metabolic syndrome. Sport and
movement can be utilised in the treatment of a number of illnesses ranging from metabolic
syndrome with its accompanying illnesses, e.g., insulin resistance, type 2 diabetes, lipometabolism
problems, high blood pressure and obesity as well as a variety of heart and lung conditions such as
chronic obstructive bronchitis. A well-implemented training therapy (a combination of
weight/strength training, endurance training and coordination training) can improve the
psychosocial and bodily well-being as well as the fitness condition of the people suffering from the
above-mentioned illnesses. Not only that, this training may even reduce the symptoms and stop the
advancement or even reverse the progress of these diseases.
Thus innovative technologies must be developed not only to keep people healthy longer, but also to
make the therapy process more effective while simultaneously reducing costs after health problems
have appeared. In the framework of the project Health@Home, a novel therapy process based on
modern IT-technology will be developed to allow elderly people at risk of health problems to
participate in a continuous medically controlled health training programme in the comfort of their
own homes (Home-based Training). Thus, costs in comparison to the current conventional
stationary stays in therapy centres will be greatly reduced, and especially for elderly people, the
participation in medical-directed health training programmes will be much easier. Moreover, the
motivation to be more active is encouraged through constant monitoring and suggested
improvements. Especially now in the area of health training programmes for the elderly and people
in higher health risk categories, controlled strength training is becoming a more important type of
training. A precise validation of the progress of the training programme is presently only possible in
an outpatient environment and with expensive strength measuring devices.
The goal of the project Health@Home is to develop a home-based, computer-supported training
system for the elderly that is, on the one hand effective while still being very simple to use, yet, on
the other hand, it can provide the attending physicians and therapists the possibility to continuously
monitor the training progress, on which to base their further medical decisions (Decision Support
System). The system will be implemented and executed within the framework of a pilot study that
will consist of 70 -90 end-users under clinical observation. The expansion of the proposed system
to include recognition and data capturing of exercise movements in targeted training programmes is
planned within an international framework. With this system, it will be possible to control complex
training programmes and, as such, to be able to provide more advanced feedback to the end-users.
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END-USER INVOLVEMENT
Barbara van der Linden1
1. Rationale
The involvement of end-users is a big issue in the AAL JP - and for good reasons.
AAL solutions have to be ‘wanted’ by older people and their families and also by the carers or
service providers that are supposed to work with the solutions or the organisations that have to
provide or finance them. The average ICT-solutions designer – being a (relatively) young
technically oriented person – in general has no clear insight in the needs of older people. Although
general studies on needs and wishes of older people can definitely give insights and directions, it is
not sufficient.
Only the real involvement of the different types of end-users can realise real solutions.
Special attention is needed when solutions for people with cognitive impairments like dementia are
developed.
In the successive stages of the designing process, the role of end-users will differ; varying from
expressing needs to testing usability and assessing usefulness of solutions. In all phases, serious
involvement of end-users can highly contribute to the quality of the solutions and the marketability
and implementation of the products and services.
2. Encouraging user involvement of older people in technology: End-user groups
2
and how to involve them - Sidsel Bjørneby
Due to demographic changes, we must realise that old people have to accept that technology is part
of active participation and care work. Old people are less homogeneous than younger people, not
only because of age, but because life has treated them differently. The most difficult group of older
people to involve in the development of new technology is people with dementia. They are also the
group that is most rapidly growing, an estimated doubling within 20 years, posing a major challenge
to care services. Care services providers will need to combine medical care and nursing with
adapting housing and designing ICT that can support end-users, helpers and stakeholders in society
at large.
1 Staff member Implementation and Innovation at ZonMw, The Netherlands.
2 GERIA, Oslo municipal resource centre for dementia.
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The basic needs of people with dementia that need to be met by ICT support are memory,
independence, orientation for time and place, activity and entertainment, and wellbeing. Meeting
these needs will also help the carers managing daily life. The easiest group to start with are persons
with an early dementia, still living at home. Involvement must be very early in the design process
and throughout user trials of prototypes.
The aim is to reach a point where the designed ICT solutions will combine usefulness, user
friendliness and acceptance by the users. Methods to include users with dementia in these
developments can focus on four steps. The steps, in order, are Attention, Interest, Desire and
Acceptance (AIDA).
Combined with these steps it is essential to have knowledge about communicating with persons
with dementia, understanding that this process is time consuming, having genuine respect for the
user’s situation and opinions, and thorough user requirement specifications. This way it is likely
that the users will appreciate being involved and contribute with valuable knowledge in the design
process.
Speakers CV
Sidsel Bjørneby is an advisor and occupational therapist at Geria, Resource Centre for Dementia
and Old Age Psychiatry, Oslo, Norway. She has worked with human factors and user aspects of
technology for older people since 1988 and recently mostly in relation to people with dementia.
Several EU projects (TIDE ASHoRED, TED, ASTRID, ENABLE) and Norwegian projects,
amongst others on smart house technology and the Internet. She is presently participating in a
working group on the use of GPS, and planning a demo flat for products and systems for people
with dementia in Oslo.
3. Social networking: success and failure factors of www.50plusnet.nl, an internet3
based community for older people - Beppie Spruit
50plusnet.nl is an internet community in the Netherlands for older people which has more than
27.000 active members. You can meet people of your own age through 50plusnet and it provides
the possibility to get in touch through chat and mail. 50plusnet is aimed at people who wish to
extend their social network. It facilitates online joint activities of its members. People are linked up
through a matching system in order to share a hobby, go out together or engage in sports activities.
The objectives of 50plusnet are:
To get older people out of isolation and/or to prevent older people from becoming isolated;
To stimulate participation, independence (ability to take care of yourself) and the social
involvement of older people;
To support ‘Self-management’: to motivate older people to take the initiative;
To stimulate (physical) activities of older people and to promote a healthy lifestyle and mental
well-being.
3 Coordinator E-Health, Netherlands Institute for Health Promotion (NIGZ) The Netherlands.
75
In the subscription process, people choose one or more activities for which they are looking for a
companion: 1. Going out together, 2. Sharing a hobby, 3. Sports activities, 4. Friendship, 5. Setting
up a club/community.
Afterwards, people choose a specific activity within this category, such as cycling, walking,
cooking or visiting a flea market. People can make one to one appointments or join one of the
hundreds of clubs that have been established by the members of the site. The interested person gives
a description of him/herself. The description is done by using a multiple choice questionnaire as
research had shown that people find it difficult to describe themselves. The result of the
questionnaire is the member’s profile. After filling in the personal description, people define the
matching criteria. They can indicate the gender, age category, maximum geographical distance they
are looking for. Afterwards, the system will start looking for matches.
When we developed the site a lot of attention was to privacy. Members can send messages through
the site without revealing their private e-mail address. In addition, members can block other
members if they wish to end the contact. They can also hide their profile if they wish to interrupt
their membership.
Every week, about 6.000 messages are put on the bulletin boards of the site. There are four bulletin
boards: on average, 8.000 messages are sent every week, and an average of 1.200 chat talks take
place weekly. Between 100 and 200 members are always online. Health is a popular issue on the
bulletin board. You can read quite often that members are about to be admitted to hospital. Those
members receive many supportive messages. We also hear that their children take these messages to
the hospital and read them to their mothers or fathers.
The bulletin board reflects very well what is on the mind of older people.
Speakers CV
Beppie Spruit is currently working as Manager E-Health on the Netherlands Institute for Health
Promotion in Woerden, The Netherlands. She holds a degree in information management from the
The Hague University. Beppie Spruit has been active for many years in the field of Health
Promotion. Her main expertise and experience is in the Web 2.0 concepts and social communities.
Besides this, she has experience in training and coaching, implementation, product and project
management and developing information-systems.
4. Involvement of older people in R&TD for assistive technologies
4
5
- Walter Hlauschek , Paul Panek
When developing Assistive Technology (AT) products and services, the intensive and early
involvement of users in the innovation and design process is of the highest importance to ensure
that the intended future product will be able to meet the actual needs of the future users in their
daily life. This early involvement in the complete development process is the main object of the
Living Lab Schwechat. To reach this target, a working cooperation between main partners has been
established: (a) senior citizens, (b) local centre for senior citizens, (c) research institute Ceit Raltec,
(d) city administration, (e) companies, (f) mobile social service providers and (g) international
4 Managing director of CEIT RALTEC, Austria.
5 CEIT, planning/implementation of Living Lab Schwechat.
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contacts. Some main phases of a design process are: creation of ideas, iterative development of
prototypes, testing and evaluation.
Some main principles applied in the AAL Living Lab are: to meet the users and carers in their daily
living situation, to have regular monthly meetings with the user representatives and to be aware of
the many stakeholders (not only primary and secondary users but also financing institutions). Also
to consider is the involvements of the users as early as possible. Another main aspect is the
importance of ethics in the AAL Living Lab.
Examples of current projects are:
− “e-Home”: user-centred development of a minimal intrusive wireless monitoring and guidance
system to increase the safety and autonomy of senior citizens living independently and to detect
Activities of Daily Living (ADLs). One target of the system is detecting falls and generating an
automatic alarm in case of emergency;
− “e-Shoe”: the development of a wearable measurement system integrated in a conventional
walking shoe which is equipped with different types of sensors in order to measure several
characteristic parameters of human ambulation. Extensive sensor data fusion and interpretation are
used to evaluate and demonstrate gait characteristics in order to be able to recognise and prevent
falls of older persons;
− “interactive picture frame”: participatory design and development (with intensive end-user
involvement) of an interactive touch screen-based voice & video over an IP phone system for older
persons which allows initiating phone calls by just touching the photograph of the person one wants
to call to;
− “Long Lasting Memories”: an integrated ICT platform which combines cognitive exercises
against cognitive decline with physical activity in the framework of an advanced AAL environment;
by enforcing this approach of simultaneously inducing neural and corporal stimulation in a safe and
controlled environment, this platform will deliver an effective countermeasure against age-related
cognitive decline;
− “Demo apartment for seniors”: establishing an apartment at the local senior’s centre showing a
barrier-free dwelling environment and AT-equipment to interested persons and acting as a test and
demonstration environment for newly developed AAL technologies as described above.
Speakers CV’s
Walter Hlauschek, managing director of CEIT RALTEC since 2007, holds a master’s degree in
electronic engineering from the Vienna University of Technology. He has been working in the area
of ICT and electronics for more than 30 years. His main expertise and experience is in the
architecture and concepts of complex circuit and packet-based switching systems. Besides his
technical skills, he has experience in management of R&D organisations, product and project
management.
Paul Panek holds a master’s degree in Communication Engineering. Since 1993 he has been
working in the field of Rehabilitation Technology in the group of Prof. Zagler at Vienna University
of Technology. His main areas of interest are man-machine interface for multiple impaired persons,
alternative and augmentative communication (AAC) for profoundly and learning disabled children,
environmental control systems (ECS), self-adapting bath room systems for disabled and old persons
and the application of telematics in the area of Assistive Technology. Since November 2006 he has
been employed at CEIT participating in the planning and implementation of a Living Lab for old
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persons and assistive technologies. He has been involved in the coordination of EU funded RTD
projects in FP4, FP5 and FP6.
6
5. User’s role in innovative projects - Luc de Witte
Innovations in assistive technology and health can only be successful when they fit the needs and
possibilities of end-users. When this is not optimal, the innovation will not be accepted and
implementation will be difficult. Therefore, the involvement of end-users in innovation processes is
essential. It is not easy to really involve end users successfully. Mostly their involvement is limited
to participation in a kind of advisory board. In two EU-funded projects, FORTUNE and USEM, we
tried to develop criteria for successful user participation in innovation projects, and developed a
training programme for end-users who want to participate in such a project. The result was a list of
seven principles:
1. Co-operation should be based on equal partnership;
2. User representatives in projects are members of an organisation of end-users;
3. Financing participation should not be a barrier for participation;
4. All process materials, communication and premises are made accessible to the users;
5. Every partner has to provide qualified representatives for the process;
6. The planning of the standardisation process contains appropriate planning of user participation;
7. Users are partners from the very beginning of the project.
Working with these principles is not self evident. Researchers as well as the end-users have to learn
to work together. The training programme we developed for end-users seems to be effective in
supporting them in this task.
Speakers CV
Luc de Witte is currently working as professor of Technology in Care at Maastricht University and
Zuyd University in Heerlen, The Netherlands.
Luc de Witte has already been active for many years in the field of technology and care as manager
of research and development and as manager of the cluster technology and accessibility at Vilans,
the national centre of expertise for long-term care in The Netherlands. He has also been an associate
professor in technology in care and in autonomy and involved in the participation of people with
disabilities at Zuyd University of Applied Sciences.
After the short presentations, a corner of the room was made available to each speaker. People from
the audience could go to the speakers with questions and discuss the presentations.
6 Professor, Technology in Care, Zuyd University Heerlen, The Netherlands.
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ETHICAL ISSUES
Antonio Mendes dos Santos1
Rationale for the session
AAL technologies and applications bring forward many questions on ethical issues. As always,
issues like systems reliability and safety, privacy (regarding data entry and exchange) are at stake,
which have already been debated for a long time, albeit in different application environments. Smart
surroundings, constant monitoring of different body functions or activity levels can help to save
people in urgent situations, but they are also amenable to keep people under constant surveillance.
What does this mean for the end-users and their families and how does it affect their lives and
relationships? What do telecare solutions mean for the quality of care, for personal contact, for the
quality of work? How to act if people are not able to give informed consent? How can the dignity of
older people be guaranteed? How does the use of smart technology affect personal relations with
family and friends? What is the effect of living in ‘your own little hospital at home’?
The debate about these issues has hardly begun. The AAL Forum is one of the places to start these
discussions at a European level, to identify relevant issues to be considered (not only theoretically
but also under a practical perspective) when developing and using applications, as well as in the
AAL Joint Programme itself.
Robots: ‘Mechanical love’; entering robots in elderly care
- Ms. Lone Gaedt2
Abstract
The presentation focused on the PARO-project conducted by DTI (PARO is a robotic baby harp
seal with social and therapeutic effects). The project focuses on documenting the effect of using
PARO, as well as it identifies preconditions for successful interaction between humans and robots
etc.
Target populations for the project are primarily people with different types and degrees of dementia
and brain damages, including people with complex, multi-faceted and severely debilitating diseases
and cognitive and behavioral symptoms or loss of function.
1 Chair: Antonio Mendes dos Santos, UMIC - The Knowledge Society Agency; Ministry of Science, Technology and
Higher Education; Portugal.
2 Ms. Lone Gaedt, Physiotherapist, Senior Consultant; Centre of Robot Technology, Danish Technological Institute.
79
The presentation described concrete ethical aspects based on the experiences in the project so far, as
well as care-professional conclusions: Paro can be a supplement to, enrich and qualify care-giving;
Paro can evoke and catalyze (earlier, forgotten) personality, feelings, behavior, spoken language,
memory; Paro can´t substitute caregivers (but reduce their strain), caregivers should rather be the
´professional managers´ of Paro. Caregivers must be confident with and motivated for creative use
of Paro, i.e. they must learn how to use Paro (professionaly and ethically) at a one-day Certification
Course, in order to have an individual approach to every unique user. Paro also can entertain, win
confidence and stimulate laughter, anger, creativity, communication, discussions,
(self)performance, spontaneity, dreams, caregiving etc.
The presentation concluded that Paro and Welfare Technology in general are neither bad,
threatening, dangerous nor unethical, but that the way it is used and organized is important. And
that technological development therefore should not be stopped but controlled, in order to see
whether, how and where it can enrich lives and life quality, support independence, reduce needs for
caregiving etc. Finally the presentation recommended that fear, horror scenarios and statements
about robots as ´unethic´ should not stop development, testing and visions, - as human beings we
should not react as programmed, simple robots ourselves.
Speaker’s short CV
For 30 years Ms. Gaedt has been working with - and teaching about - old people and their physical
and cognitive resources and handicaps.
During the last 5 years she has focused on - and got experience from - people with dementia
particularly when using (high and low) technological helping aids, systems and possibilities for this
target group.
Currently she is involved in testing and evaluating different new robot-technologies within the
elderly care in general, and specifically leading the Paro-project.
Ambient Intelligence; ethical issues in application in health and care
- Prof. Jan Gerrit Schuurman3, Mr. Michiel Besters4
Abstract
Ambient Intelligence is a vision on the future development of care technology. It promises
personalized care: care that is carefully tailored to the person, and where possible, fully automated.
In the Ambient Intelligence vision, five consecutive layers of technology are identified, each
building onto the previous one and each with an increasing number of automated aspects: (1)
embedding, (2) context-awareness, (3) personalization, (4) adaptation, and (5) anticipation.
Ambient Intelligence does more than merely introduce new functionality to the life of citizens and
patients. The more we progress in the Ambient Intelligence vision, from the integration to the
anticipation level, the more we expect of the technology. It has the potential to improve the setting
in which people live, providing greater comfort, anticipating events, making technology more userfriendly, adapting to the user, and thus enhancing quality of life.
3 Prof. Jan Gerrit Schuurman, Visiting Professor, University of Lincoln, UK.
4 Mr. Michiel Besters, Researcher, Rathenau Institute, The Netherlands.
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To provide personalized care for everyone, the relevant parties in a care network around the
individual users must exchange detailed information about their health. This formation of networks
is essential for the personalization of care, yet it is also the biggest threat to it. Firstly, healthcare
practitioners, health insurers, government agencies and other such parties may wish to make use of
an individual’s health information yielded by intelligent surroundings. Such use is not necessarily in
the patient’s interest. Secondly, since active involvement of the user is often a requirement, it
becomes an issue whether people have the requisite competences. Consequently, all kinds of
normative questions come to the fore: greater independence versus new forms of dependency and
social isolation, self-care versus behavioral control, the quality of healthcare, and privacy issues.
Regarding the promises, expectations and normative issues, the question is raised whether the
vision of Ambient Intelligence has a viable future or is a dangerous illusion.
This presentation at the AAL Forum 2009 is based on the study “Ambient Intelligence. Viable future
or dangerous illusion?” of the Rathenau Institute, a Dutch think tank on science and technology.
The study can be downloaded from the website of the Rathenau Institute:
http://www.rathenauinstituut.com/showpage.asp?steID=2&item=4070.
Speakers’ short CV:
Jan Gerrit Schuurman (1967) is a visiting professor at the University of Lincoln (Faculty of
Health, Life and Social Sciences), where he holds a chair in health and community development. He
leads a cancer rehabilitation programme in the Netherlands.
He read experimental cognitive psychology at the University of Groningen before obtaining a
doctorate from the University of Twente in 1999, with a dissertation on knowledge transfer in ICT
training.
Since 2000, he has been involved in various health care sector projects commissioned by the
Erasmus Medical Centre, the Utrecht University Medical Centre, the Dutch Cancer Society, the
Ministry of Health, Welfare and Sport.
Michiel Besters took his Research Master in Philosophy at Tilburg University in 2007.
Since September 2008, he is working at the Rathenau Institute on projects in which different kind of
technologies (medical, surveillance, and databases) are assessed in terms of their cultural, societal
and political significance.
Ethical dimensions in the involvement of older end users in technology R&D
projects - Dr. Marjo Rauhala5
Abstract
There are a number of reasons for the need to pay close attention to ethics in the research and
development of AAL technologies. The fact that the target group of AAL technologies consists
predominantly of older people, some of whom may be considered vulnerable, forms an obvious
reason for addressing ethics. Furthermore, the applications in question tend to be intrusive, bringing
many privacy and security issues to the fore. The context of use of AAL applications is the private
5 Dr. Marjo Rauhala, Researcher, Vienna University of Technology, Austria.
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home; little is known about how the introduction of new ICT-based technologies into the realm of
the private home affects the feeling of being at home. Not only are older primary users of AAL
technologies and the lives of those users affected by the introduction of new AAL applications, also
their family members are likely to feel some changes. The allocation of responsibilities of care
followed by implementation of new care-related technologies in private homes has been recognized
as a significant issue that needs to be dealt with also from the ethical point of view. In addition to
these rather obvious reasons for taking ethics into account in the AAL field, some less obvious ones
also figure in, namely the fact that AAL technologies do and will participate in shaping our
discourses about the very basic questions of ethics, such as what is the good life? What is good
care? What kind of society do we want to live in? How should we treat others who are potentially in
a weaker position? In order to appropriately address the diverse ethical issues that are likely to
surface in the lifecycle of AAL applications, the author suggests a comprehensive and systematic
look at ethics in the AAL field.
Speaker’s short CV
Marjo Rauhala (PhD; MSSc., BA) is an ethicist and social scientist currently employed as a
researcher at the Institute “integrated study” at the Vienna University of Technology.
Her work focuses on investigating ethical dimensions of technology research and development,
especially with vulnerable user groups, and ethical review of R&D projects.
In her approach to ethics in technology R&D contexts, Dr, Rauhala combines methods of empirical
research and traditional academic ethics.
The discussion:
After the three presentations and in order to provide a lively start of the discussion, the Chair asked
the audience to “play an opinion game” - the following assertive statement was shown on the
screen:
AAL systems and applications bring forward a new specific set of ethical issues
requiring specific research and legislation on their own.
The people in the audience (there were 56 persons at the start of the session, increasing to about 70
by mid-session) were then requested to move to the left of the room if they agreed with the assertion
or to the right if they did not.
A noticeable majority (~75%) agreed with the statement. Then, the Chair asked two persons from
each side to present short speeches “defending” their view. The most noticeable view expressed was
that of a medical doctor, who did not agree with the statement, arguing that the well-researched
field of “Ethics and Medicine” provided a safe and ample enough basis for the needs of AAL.
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BUSINESS MODELS
Juan Carlos Castrosin Gutierrez1
Speakers and Topics
Hubert Oesterle2: Collaborative Business Models for Independent Living
Peter Rumm3: Business Development in the PERSONA Project
Peter Levene4: CARING FOR PATIENTS, supporting Vulnerable and Elderly People at Home
and in the Community
Nissim Darvish5: Trends in Healthcare
In Europe the environment of national health care and social security systems is rather
heterogeneous. This hinders the development of common (European) business models and a
common market for AAL solutions. Currently, reimbursement schemes in most countries do not
encourage the adoption of technological innovations in these systems and provide no clear
perspective in linking investments and revenues/savings for adopters. Investors and developers have
to deal with a wide variety of welfare, healthcare and care systems in European countries. Each of
these systems provides a complex legal and regulatory basis which restricts or encourages the use of
AAL technology in the public healthcare and care services in specific ways. In both, the more
regulated markets of healthcare/care and the consumer-oriented private markets, the lack of visible
value chains is obvious. The complex structure of the developing AAL markets and the lack of
market information and visible value chains make it difficult for SME or entrepreneurs to develop
business strategies and evaluate the future market potential in this sector. To foster the market entry
and participation of (innovative) SME and start-up companies in these important (technology and
service oriented) market segments, it is important to stimulate innovation and deployment in the
whole AAL ecosystem.
In his introductory remarks, Juan Carlos Castrosin Gutierrez explained that, in a general view, any
business model is a representation or basic framework for any type of value creation – be it
economic, social or otherwise. For any type of company, a business model is of crucial importance:
established companies need to innovate their business model(s) constantly or find new ones to
compete against competitors. Start-up companies seek to establish new business models to enter
existing markets or to create new ones. Economic history shows that the cycle of creation and
innovation of business models has accelerated in the past decades. However, every business model
is built of several basic building blocks which need to be considered when thinking about possible
1 CEO Platform of Investments and Powerful Inventions PI&PI, Member of the AAL Advisory Board.
2
Director of the Institute of Information Management, University of St. Gallen.
Project Manager, FutureCamp GmbH.
4 Business Development Director, Docobo Ltd.
5 Partner, Pitango Venture Capital.
3
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entrepreneurial strategies: Value Proposition, Market Segment, Value Chain Structure, Revenue
Generation and Margins, Position in Value Network, Competitive Strategy, Cost Structure, and
Distribution Strategy.
Hubert Oesterle in his talk emphasised that the demographic changes in Europe, especially in the
care sector, will lead to a need for services for older people on an industrial scale. Without further
efforts to enable more people to live independently at home, the future costs for care homes and
services will not be fundable. Industrial players like Philips, Tunstall and others have already
entered this growing market. In most cases, new technology and new services have together
established new business models in the past. Services in independent living need to support and
cover a combination of consumer activities in related areas, e.g. housekeeping+care+security+social
participation. Through interviews with potential customers, Oesterle and his team were able to draw
a matrix of preferred services packages from a customer’s point of view. By clustering these
packages, a certain set of services with market potential could be identified. When thinking about
the provision of these service packages, potential service providers face a dilemma: if the services
are not attractive and comprehensive enough, there will not be sufficient customers. If there are not
enough potential customers, service providers will not take the risk of offering the envisaged set of
services. In order to escape this dilemma, two approaches are reasonable. A break-through killer
application might be developed, thus solving the dilemma and breaking the barriers. However,
applications like that are not easy to find. Another solution could be the development of an
ecosystem for independent living. In such an ecosystem, consumers and suppliers of different
services are linked via a service platform. This (electronic) platform handles the determination of
user demand, the selection and ordering of appropriate services, the execution of the service and the
payment procedures. It operates as a middleman between the users and the providers of certain
independent living services. In order to enter the game in such a model, companies need to define
and find their role in the value chain and become part of the IL supplier database which is part of
the whole ecosystem. When putting the pieces together, customer demands, market overview,
market potential and existing solutions are connected in the IL ecosystem. The University of St.
Gallen has set up such a network (IL Network St. Gallen) with members (user organisation, service
providers) from Switzerland and Germany. Practical experience shows that such an ecosystem is
successful in reducing the complexity for the consumers. Good management of the whole
ecosystem is the key to success in order to establish sustainable business models. In the discussion,
it was mentioned that building an ecosystem with a heterogeneous group of companies needs
standards and guidelines for collaboration which is a highly political issue. It was also emphasised
that the consumer needs to be in the middle of the ecosystem. This also pointed to the fact that
speaking about the “user” (in a R&D context) is not necessarily the same as speaking about the
“consumer” (in business terms).
A different approach to the IL network has been implemented by the Persona project, which was
presented by Peter Rumm. Persona (Perceptive Spaces Promoting Independent Aging) is an EUfunded project with 21 partners and duration of 42 months. Part of the project is the exploration of a
high-level (IT) architecture for independent living services which involves home-located devices
and middleware, and web services to connect to outside medical and care service providers, and
other stakeholders. The business model and strategy development in the project was based on the
(hypothetical) Persona Ltd Persona Ltd would combine a technology platform, AAL services and
service provision to the customer, together with external partners from the relevant sector. In order
to provide the right kind of services to the end user, a customer analysis was undertaken in which
target customers, their market power, potential weaknesses and necessary resources of the Persona
Ltd were analysed. As a result, a list of the most promising services with the most market potential
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(and prospective numbers of users) was developed with personal health management and
emergency and risk management in top position. The case of the Persona Ltd showed that market
entry of new companies needs a mix of technology push and demand pull by the customers.
Thinking in terms of products and offers to potential customers is important when making the step
from research to business models.
The real-life example of UK SME Docobo was presented by Peter Levene. The company,
established in 2001, is active in the telecare sector. The starting point for the business was the great
potential to help people, the potential market and the commercial opportunities identified in the
telecare sector. However, the entrepreneurs underestimated the necessary time to market for their
disruptive product and were also not aware of the fragmented nature of the UK National Health
Service (NHS), its inability to take quick decisions and its lack of interest in investment in health
care. The journey for Docobo became more difficult than expected. Demographics and the demand
and supply side challenges in the UK health sector showed a clear business case for Docobo’s
doc@Home service. The NHS, as the main public healthcare and care provider (and Docobo’s main
customer), was not ready to adopt new services easily: since additional spending for care
technology was only accepted for very ill people, the market for the service was not huge and was
also very fragmented. Also the NHS did not have practical experience in identifying the right
patients for the service. Concrete use cases, established with the help of carers for severe chronic
conditions, showed the real-life benefits for the ill person and the carers, and helped to overcome
some of the barriers of wider adoption. For Docobo, the telecare service is just the beginning - if the
assistive-living market is to be fully developed, a holistic approach should be implemented that
fosters case co-ordination and care convergence in an integrated and interoperable system. The
current telehealth reduces admissions, visits and calls, and therefore delivers cost reduction for the
NHS. The wider benefits of an improved quality of life (QoL) for patients and carers are relatively
out of scope and unexamined. The NHS therefore will currently concentrate on cost reduction for a
small number of very ill patients. A wider QoL-oriented approach could also stimulate the private
market and open additional business opportunities. Docobo is engaged in new research projects (i.e.
integration of telecare and telehealth, and wearable systems or personal care systems) that could
lead to new business models in this field.
Finally, an investment perspective on ICT and ageing was given by Nissim Darvish from Pitango
Venture Capital. In this perspective, the global healthcare industry is an exciting industry forming
8% of the world GDP. There is a strong growth in medical devices and biotech driven by
continuous innovation. Demographic change will also shape the future of this industry in an
immense way: ageing and declining populations, and increasing life expectancy, changing family
structures and shifting patterns of work and retirement together with a growing burden of chronic
diseases will lead to rising healthcare expenditures and emerging economic challenges. The
pressure on healthcare systems fosters the need to reduce healthcare costs by investments in IT, the
implementation of preventive care and disease management programmes and the coordination of
care among providers. This opens new business opportunities for healthcare information
technology, home health care and the development of new drugs. Here, venture capital investments
can play an important role as an economic model for new market creation and modernisation for
healthcare reform. There are already large investments in healthcare, hardware and software, and
healthcare IT (HIT). Home health care services and novel drugs development will attract additional
VC in the future. Upcoming information technology innovations will allow critical medical data,
including images of the operating field, to be processed and transmitted rapidly, saving both
patients and physicians time and speeding up the delivery of treatment. Information from devices
such as pacemakers, blood-glucose test kits and blood pressure readers will be monitored over the
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internet or via wireless connections thus achieving better disease management. There are also
challenges in HIT: technical challenges like secure/wireless connections, batteries, errorless sensors
and the lack of business models, costs, interoperability, privacy and confidentiality issues, and the
demand for skilled workforce. The transformation of health home care is already taking place.
Philips entered the home health care market and seeks to become a global home healthcare market
leader in 2015. Home monitoring is a key segment in this upcoming market with devices like the
intelligent home healthcare embedded system for fall detection. Since healthcare reform is a must,
innovation will accelerate the necessary modernisation. To foster this transformation, governments
should apply leverage to the venture capital model in order to push progress ahead (e.g. direct
support for companies, tax incentives, etc.). In the final plenary discussion, the question was raised
as to whether the necessary holistic systems for independent living should be targeted immediately
in research, or if iterative improvements of single one-problem-one-solution devices are today’s
better approach. In the latter sense, system compositions and merging devices into a system will be
done in the end by the market. Another issue was the importance of social business models
focussing on the benefit for society. In the projects of the AAL Joint Programme, these societal
benefits should be part of the business plans of the projects.
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AAL AS A CHANCE FOR INNOVATION
Urs Guggenbühl1
In the face of unprecedented longevity, the challenge for society is to understand and plan for how
best to enable older adults to age well, maintain their personhood and their place as members of
society and, last but not least, make sure that this is financially sustainable. The convergence of an
ageing population with today’s availability of advanced technology is an opportunity to innovate
and to think differently about how we live throughout our life span. The home is the primary
platform for much of life’s activities influencing health, wellness, well-being, independence and
safety as we age. Sometimes though, technology seems an attractive option when we are faced with
an improvement challenge. However, it is understood that technology is not a panacea for the skills
we lack or for every improvement issue we encounter. The AAL JP aims to catalyse innovation in
exploiting technology to provide not only products but services that are needed, desired and
financeable to enhance the lives of older people among member states. It recognises that technology
is a tool that complements abilities and has the potential to allow our ageing population to do more
and become more productive.
It is in the recognition of the older adult as a person first and foremost that the AAL JP addresses
the investment in supporting research and development for ambient-assisted living from a holistic
point of view. In this session, we address innovation within the AAL JP from a number of
perspectives. How can we generate creativity and innovation from the older person’s perspective,
from the perspective of family and carers, as well as that of business? The AAL joint programme
aims to distinguish itself from a myriad of other research and development ageing programmes
through its ability to challenge the various disciplines and sectors to innovate in the psycho-social,
socio-cultural, physiological and economic realms in pursuance of the old adage, live long and live
well.
Before we consider the three presentations in this session perhaps we should have a closer look at
what is “innovative”. The common understanding of “innovative” is to be creative. Everyone
always thinks of new things which could make life much easier and fulfilling, if they were
developed and offered as a new product or a new service, etc. To have a new idea is one thing, to
develop this idea into a successful product or service, etc. is another thing. Thus it is not surprising,
that innovations usually don’t fail on the idea but on their implementation. Every good idea follows
a difficult innovation development pass which is multidisciplinary, customer oriented and has a
business perspective. With this understanding we could define innovation as being a new idea
which was developed into a successful product or service, etc. with a positive return of investment.
The first presentation “Innovation in healthcare: key challenges and opportunities” was given by
Terry Young, Chair of Healthcare Systems, School of Information Systems, Computing and
Mathematics, Brunel University, United Kingdom.
1
Director of the Innovation centre of the University of Applied Sciences, St. Gallen, Switzerland.
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Although there is much talk about the need for innovation in healthcare, there are some barriers that
are not at all obvious. A major difficulty lies in the fact that service provision is the main business
of most healthcare delivery organisations, and yet much of the innovation focus lies at the
technology level.
In this context Terry introduced MATCH (Multidisciplinary Assessment of Technology Centre for
Healthcare) a joint research initiative between Brunel University, University of Nottingham,
University of Birmingham and University of Ulster as well as the Engineering and Physical
Research Council, UK (http://www.match.ac.uk). MATCH works with demand-side organisations
such as the NHS Purchasing and Supply Agency (PaSA) and its Centre for Evidence-based
Purchasing (CEP) as well as with the NHS National Innovation Centre (NIC) to develop decisionsupport methods and tools. On the supply side of the fence, embedding Health Technology
Assessment (HTA) into the product development cycle is also a challenge, especially since the
practicality of a new invention, and end-user attitudes to it, are often unclear until a solution has
been engineered. As a great deal is based on belief rather than evidence at the start, the MATCH
team works with a range of companies to develop an integrated suite of methods that connect
between the worlds of “based on belief” and “based on evidence”. This involves producing
guidelines, developing methods, and providing integrated HTA tools for business processes – for
those producing medical technology and those who take it up and use it.
By considering a simple model of innovation, Terry and his team attempt to understand the
difficulties mentioned above and to work out some ways of coordinating the introduction of
inventions into the flow of service improvement. In this context, he also introduced another line of
research called RIGHT (Research into Global Healthcare Tools) which is a collaborative research
venture between seven UK universities that aims to assess, through “proof of concept” testing, the
feasibility of applying to decision-making in healthcare, some of the best-practice modelling and
simulation methods that are used to support decision-making in other sectors, such as industry and
manufacturing, and the military. In doing this, RIGHT is applying research to a widely recognised
gap in healthcare management (http://www-edc.eng.cam.ac.uk/right).
Terry concluded his presentation with the words, innovation in healthcare is hard, especially
because of the dysfunctional interactions between the service improvement cycle and the cycle for
the invention of new technologies. Simulation and modelling, however, offer a means of
overcoming this critical barrier, while better articulation of the value of technologies should help to
improve the synchronisation and adoption of technologies.
The second presentation “AAL - transforming care, enabling choice and driving innovation” was
given by Madeleine Starr, Strategic Programme Manager, Carers UK, United Kingdom.
Madeleine’s presentation focussed on ways in which assistive technologies can deliver innovative
care solutions that have wider benefits not only to families, but to communities, employers and the
wider economy.
Innovating for family and carers simply means innovating for people. Many people do not associate
assistive technologies with their own everyday lives, often because of the way they are described
and promoted. We need to promote them as ‘tools for living’ and make them familiar and
accessible.
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Who are the end users of these technologies? We talk about supporting people to live
independently, but in reality people live inter-dependently. Services are not delivered in a vacuum,
they are delivered into relationships, families and communities, and their impact has to be assessed
on all these, beyond a single ‘user’. Technologies need to be responsive to our ordinary, everyday
NORMAL lives which will include disability, frailty and caring, all of which are normal. People
have never lived in isolation, people have always grown old, people have always been born with or
acquired disability and people have always cared. However, successes in healthcare technology
mean that we are now living longer, and living longer with disability which requires greater levels
of care, much of it family care. We are also facing a future in which we will be required to work
longer to support an older population and a growing care and pensions bill. These are powerful
policy imperatives.
Assistive technologies will be a vital part of the jigsaw of support needed to manage complex
interdependent relationships – family, community and working relationships. All relevant
stakeholders will need to be engaged in developing, using and, above all, mainstreaming these new
technologies, and are the real market for them.
We need to make consumers visible in the development and marketing of these new ‘tools for
living’. Consider that in 2008 in the UK £244 million was spent by private purchasers and £177
million by local authorities on aids and adaptations. At the same time, £167 million was spent on
anti-ageing creams – and who is the most visible of these two consumer groups? Most consumers of
assistive technology have no part in the choice of what they use, and do not know what is available
until they become users. However, women from as young as 20 – and as old as 70 – are targets for
the marketing of anti-ageing creams which are sold on the benefits of the science they incorporate,
and with the empowering message – ‘You’re worth it’.
I might argue that my mother and I are worth great technology support to manage my care of her,
her care of me and my family, her participation in her local community, and my working life. And
of course we are, as too are her local community and my employer, but none of us really knows
what choices we have about what is available, where we can find it, or even how we pay for it, no
matter how much it might help.
It is time to mainstream this technology, to make it about lifestyle choices, to design it beautifully
so people want it, to sell it commercially and to target its marketing beyond what is often
characterised as the immediate end user and the other parties who will benefit from it.
We should, however, not only focus on the hardware – we have to transform the response services
that underlay a lot of these technologies and see private investment as well as public investment in
these too, with venture capital embracing the call centre or triage service in the same way it
embraced internet shopping.
If these technologies are to be mainstreamed they must be designed for real people and marketed to
them in ways that make sense to their real lives. Only then will we truly see demand-led innovation.
The third presentation “What is wrong with AAL?” was given by Dirk Elias, Executive Director of
the Fraunhofer Portugal Research Centre for Assistive Information and Communication Solutions
(AICOS).
In his presentation Dirk questions the effectiveness of R&D funding for AAL related projects in
health care on national and international levels. Technologies to implement AAL services are
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available and stable. Lab tests and living lab trials show a general usefulness and the value of the
product. Although there is a huge potential market in Europe and today some regions of Europe are
already facing a demographic ageing problem greater than the average predicted for 2025, AAL
products are still rare and no significant market success can be observed. The reasons for this
mismatch according to Dirk are:
• the lack of a definition of a reasonable common denominator from a large amount of
requirements from a magnitude of stakeholder needs,
• the focus which should be on elderly people and not on the sensors,
• the policy makers who are suffering from the “Boiling Frog Syndrome”,
• only a technically integrated ecosystem will be able to provide a sustainable mass market for
AAL solutions.
Dirk argues that the problems we will face due to the demographic change already exist today. In
Portugal for example, there are some regions where the elderly population (65+) is already larger
than the 20% of the national average predicted for the year 2025. He sees a solution by collectively
defining a primary care standard. On behalf of the Health Cluster Portugal (HCP), AICOS is driving
the development of a national project called AAL4ALL. This project aims to bring together all key
players in this field, to define together a primary care standard, design the appropriate business
models and adapt to already existing international standards. Dirk also calls on the other European
countries to participate in creating a common denominator for a “Public Primary AAL-Care
Standard” to be able to create mass markets within and outside of Europe. For this he has set up a
questionnaire
available
to
everyone:
(http://aal4all.projects.fraunhofer.pt/aal_questionary_final_verteilt.pdf).
Although 70% to 75% of elderly people are in good health, these three presentations and the
discussion which followed showed clearly, how AAL is still dominated by health care issues. For
the next AAL-Forum in Denmark, we hope to see more presentations focussing on aspects of AAL
solutions for elderly people other than only health care!
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STANDARDS AND INTEROPERABILITY
Jeroen Wals1
Speakers and Topic
Ger van den Broek2: Standardisation in AAL
Marco Eichelberg3: Interoperability in AAL
Chuck Parker4: Interoperability and Certification Activities in the Continua Health Alliance
Ad van Berlo5: Interoperability in Smart Homes
Standardisation is a prerequisite for a broad deployment and use of ICT, and triggers and enables
new business. The ICT standards community is characterised by a large number of standards bodies
and indeed a large number of different types of activity, spanning over a wide spectrum ranging
from the infrastructure, represented by the Internet and basic communications standards to the
content standards. It is commonplace to state that ICT standards are (or should be) global, and that
“regional” standards have no place. If anything, ICT standardisation is becoming more critical an
issue. This is particularly true in the context of AAL Technologies. There are many different
subjects for AAL Technology standards, for example, hardware, technologies, software,
interfaces/architectures, processes, services, data, content, etc. Each may require a different
approach, or involve different actors and methods. Establishing such standards economizes on coordination costs, creates an integrated market with economy-of-scale advantages and helps to build
trust in quality of devices and services, where error-free functioning can be critical to the individual.
Another approach to achieve the necessary interoperability is certification on product level. Here
the Continua Health Alliance – an industry-driven global consortium – has taken first steps and
established design guidelines and a product certification process for health and medical devices.
Another important sector where interoperability is crucial is the Smart Home. Here a wide range of
different services and application - provided remotely or existing solely within the home
environment - are connected for creation of information or data, its processing, aggregation,
understanding, delivery, actions based on information received and display to some user or
operator. In the end service delivery and home based applications are to be operated independently
of underlying technology.
Ger van den Broek explained the basic approach towards standardisation that has been used in the
AALIANCE project. His starting point is the observation that the Ambient Assisted living domain
consists of a large variety of independently developed systems and services. An added value can be
expected when data from these systems and services can be exchanges, aggregated and used by
1
Vice President Philips Research Healthcare Program; Member of the AAL Advisory Board.
Senior Scientist, Philips Healthcare.
3 Head of Working Group “Interoperability” in the German Innovation Partnership AAL, OFFIS e.V.
4 Executive Director, Continua Health Alliance.
5 Manager R&D, Smart Homes NL.
2
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reasoning services to provide better support for the individual client. This however can only be
achieved if the systems and services are interoperable and can be dynamically integrated. HL7
(Health Level Seven - used for the exchange, integration, sharing and retrieval of electronic health
information) defines interoperability in several dimensions: Systems should fit in existing
environments (physical and environmental interoperability), they should be able to communicate
and to exchange data (technical or syntactically interoperability), they should be able to understand
each others data (semantic interoperability) and be able to process and use the exchanged data in
compliance with their internal procedures (process interoperability). These different dimensions of
interoperability can only be achieved when standards are being used. Speaking about standards in
general, we see that there are categories of standards – they could official/mandatory or voluntary, it
could be proprietary or open standards. Of course, industry groups play an important role when
standards are developed and adopted. The landscape of standards presents itself rather
heterogeneous: conflicting version of standards exist (or conflicting implementations of the same
standard), in certain areas there is a lack of specific standards or a lack of certification of products
and services. There are a lot of barriers for standards adoption. On a supplier side, typical barriers
for standards adoption could be the following: primary focus on internal efficiency (not on external
connectedness), standards do not follow user needs, so it is difficult to adopt them. An organisation
might be ignorant about standards or is not willing to take the costs of implementation or migration.
A care delivery organisation might be hesitating to adopt standards because it also has a focus on
internal efficiency or a lack of financial incentives to adopt information technology and the
accompanying standards. Furthermore there might be political barriers, regulations or barriers
within the standard development organisations which hinder development and adoption of a
standard.
In the context of AAL there a different types of standards: Equipment and environment standards
(like home and building electronics, etc.), generic technology standards (like PAN, LAN, WAN,
web based services, middleware, etc.), domain specific standards (healthcare, home control,
infotainment, shopping) and AAL integration standards like exchange formats and ontologies. The
later one is the most important one for the creation of a whole AAL eco system with different
subsystems and service – development of these standards is at the beginning and has just started. In
the AALIANCE project a first inventory of related standards in AAL has been developed. A
number of standards in the domain in different categories have been identified: 11 domain specific
standards, 9 on equipment and environment and 14 on generic technologies - and there may be
more (Document available on http://www.aaliance.eu/public/documents). The Cenelec standard for
smart homes for example consists of several subgroups of different standards in the area of
installation, certification, communication, applications and architecture and hardware requirements.
There is a wide range of different actors in the AAL and standards field. (EU) research projects in
AAL do often use standards, but only few of them are actively contribute to standards development.
The Cenelec group is working on a related roadmap in this area. Also the TAHI Home
Interoperability Framework Initiative and the Continua Health Alliance must be mentioned. What is
needed at the moment is more awareness for the need, problems and opportunities of
standardisation in AAL. Also researcher and developers should identify and select standards and
promote the use of these standards by developing deign guidelines with these standards. Also more
labelling and certification of products and services will be needed. In the discussion the need for
sharing information between the different organisations and groups active in standardisation was
emphasised. Standards should not only be promoted towards the technical community but also
towards the healthcare and care sector.
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Marco Eichelberg is the head of the interoperability working group in the German Innovation
Partnership for AAL, a non-profit working group addressing issues of Interoperability in AAL with
experts from different domains. In order to present the current state of interoperability in AAL and
to give recommendation, the network will publish a 2-volume book on the issue in autumn
2009/Spring 2010 (in German). Like Ger van den Broek, he emphasised that interoperability (a term
which is not easy to define) is the result of different layers of interoperability: Protocol
interoperability (technical exchange of information) – Syntactic interoperability (exchange of data
in the right format) – semantic interoperability (understandable semantics of data) and user
perceived interoperability (effective and correct communication that leads to service provision to
the user). Although the later is the main target, the other layers are necessary preconditions for it.
The ability to connect and exchange information is one of the distinguishing marks of AAL systems
and this makes interoperability indispensible for AAL. Much research is going into AAL currently,
but with regards to standards, interfaces and interoperability the developments so far are
fragmented, uncoordinated and often proprietary. A situation very similar to the state of medical IT
10-15 years ago. A consolidation towards a few interface standards for AAL is therefore quite
desirable. When connecting devices a lot can go wrong: connectors don’t fit (.e.g. USB), different
network protocols are used (Bluetooth, ZigBee, and WLAN all use the same frequency) or different
transport protocol (HTTP, SOAP, RTP, WebDAV, HL7 MLLP) and different application level
protocol (i.e. ECG transmitted in DICOM, HL7 aECG, SCP-ECG, or ISO/IEEE 11073-10306
format?). Finally there a lot of different interpretation (semantics) of data transmitted (Character set:
ASCII, UTF-8, UCS-2 or Latin-1, HL7 “veteran’s military status” vs. “patient’s profession”, a
problem of translation and context). In AAL there additional and multiplied challenges. AAL brings
together components, products and vendors from different market segments:
Building automation, Household appliances, Medical devices, Consumer electronics, Microsystems
technologies, Telecommunications. These all have different standards, different terminology,
different products, and address very different markets in terms of price sensitivity, distribution
channels, market „players“ etc. Who can design a system that combines vital signs with data from
building automation, detects an emergency, establishes contact via a TV set, switches off a cooker,
and calls for an ambulance? There is a multitude of relevant standards and norms which poses a
challenge for product designers, developers, integrators. There are also rivalling standards. In an
ideal world, we would have exactly one standard for each task or interface. In reality, there are often
overlapping or rivalling standards, driven by different vendor “camps”. So what can an AAL
developer do? Supporting all standards is too expensive. Wait for one standard to replace all others?
This will probably no happen. Implement a software abstraction layer that permits certain
interfaces/standards to be replaced? Good if possible. Choose one standard and accept
incompatibility with all others? Bad, but sometimes this is the only choice. Also same standards are
missing completely: For many topics relevant for AAL, there simply are no standards (with market
acceptance) yet – e.g. remote maintenance of AAL systems, connection to medical sensors, AAL
terminology/AAL Middleware/Service Execution Environment, Emergency Calls and Connection
to Call Centres. This forces everybody to “re-invent the wheel” with every new product/project. The
integration with existing healthcare IT is another crucial point. AAL technology enables us to
permanently monitor relevant health parameters at home. How can we secure that the AAL system
at home „knows“ which values are critical for the patient and that the data measured at home is
available to the family doctor or specialist for follow-up? This requires connectivity between
„professional“ healthcare IT and AAL systems at home, but IT infrastructure in hospitals and
practices is not prepared for this at all. (The fact that health insurance (at least in Germany) will not
pay for such services does not help either…). Product labelling needs also to be addressed in AAL.
When purchasing a device such as a scale, the product‘s classification with regard to reliability and
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precision is not obvious: consumer product (fitness, wellness) or medical device - both carry a CE
mark. When purchasing a component, it is not easily possible to determine whether or not that
component can be integrated into an existing AAL system. The capabilities of an AAL product
should be described through a harmonized terminology (compare DVD players: plays MP3, plays
VCD, supports 5.1 audio…). This calls for a harmonized approach towards product labelling (and
possibly certification) in AAL. All these challenges make it clear, that Interoperability is one of the
topics AAL research needs to address. However, Interoperability is just one out of many challenges
AAL research needs to address: Robustness (systems that work in “real life”), Sustainable business
models (hybrid products etc.), Usability and the necessary training for planners, plumbers &
technicians. In the discussion, the need for a comprehensive overview of the AAL standards
landscape for the European AAL community was expressed. It was also mentioned, that issues of
safety and security have a very close link to standards and interoperability and should therefore not
be forgotten.
The certification activities of the Continua Health Alliance were presented by Chuck Parker.
Continua was founded to organize the market participants and to establish an ecosystem for
development in the remote patient monitoring area including developer resources, market
intelligence and collaboration among the members. Over 1,400 members are currently participating
in the various Working Groups – involving all supply and demand side industries: Medical devices,
Governmental Agencies, Fitness, Pharma, Health care providers, Health insurers,
Telecommunications, IT, Integrators, Applications (PHR, EHR, desktop). One strong value of
Continua is the certification program for interoperability of devices. In its working groups, realworld use cases from industry and healthcare are modelled. In the working process then the
requirements are being deconstructed and the best industry standards are selected. The processes are
examined closer and existing standard holes are directly closed within SDO’s or additional
definitions and refinements are defined. After selection of the connectivity standards, the guidelines
for strict interoperability are published. Continua has also established a test and certification
programme – certified products will receive a recognizable Continua logo. To organize its work,
Continua segmented the market in three large use cases: Aging Independently, Health & Wellness
and Disease Management. Here the different single use cases are developed. The complete system
consists of PAN/LAN devices, application Hosting device, WAN device and the health record
device. Current use cases (V1.0) focus on PAN and LAN interfaces. The next use cases (V2.0) will
go towards Service (WAN) interfaces. Current V1.0 use cases cover protocol standards, syntactical
(data) standards and semantic interoperability. V2 will have further implementation and conditional
understanding. In its activities, Continua uses a three-tier approach in interoperability. Continua
constrains the outputs at the device level (PAN interface) (which reduces device overhead and
intelligence requirements, power requirements, development time and connection complexity) and
locates the intelligence at the Hub / Manager. Reference devices exist for all device classes. When
taking the Continua certification, members need to provide the SDO transport certificate, test plans
will be developed and in the Continua test lab the certification tests will take place. When tests are
successful accomplished certificate and logo will be provided. The logo shows the user/customer
that these certified devices will work together in safety-critical health-related environments.
In Continua’s view the remote patient monitoring market will be driven by a number of significant
changes or trends. The individual home will establish as the hub for future systems. Healthcare will
be more and more tailored towards the needs of the consumer. Public health and corporate wellness
support programmes will become more and more important including rewards and public incentives
to stay people healthy. There will be a greater integration among wellness, health and social care,
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technically speaking we will see increased connectivity and evolutionary, scalable, service driven
offerings.
Some practical examples of non-technical standardization issues in smart houses were given by Ad
van Berlo, R&D manager at Smart Homes the Dutch national expert centre for smart technology
and smart living. A typical current smart home companies different numbers of ageing well
applications (safety alarms, videophones, door lock, etc.). A control hub (e.g. i2home) would
connect different controller devices, external resource servers and target devices. But apart from the
technical standards necessary to establish these connections, also non-technical standardisation
plays a vial rule in the AAL and smart home context: e.g. standardisation of user needs,
standardisation of technical design / basic electrotechnical infrastructure, standardisation of
installation, sandardisation of usability. Ad demonstrated that when a smart home is established and
the inhabitant move in, a lot can go wrong in very practical terms: Old furniture may not fit to the
existing network installations, the inhabitants are not happy with the installed network infrastructure
from an aesthetical point of view (and it may not be changed any more) or basic design and
usability principles are neglected in the installation. Strong user involvement in the design process
is therefore a necessity. What is needed are flexible technical infrastructures than can be adopted to
the user needs. Also the installers of the technical equipement (electricians, plumber, etc.) need
specific expertise of these requirements which raising the issue of professional education in these
area.
Other crucial topics are the standardisation of evalution methodologies and the standardisation of
privacy. Ad underlined there is a need for standardised evaluation methodology in AAL projects. In
many AAL projects running we find a great variety in evaluation protocols. Therefore it is difficult
to prove evidence, to find justification for exploitation and to find and establish business cases.
Commonly accepted standards (consensus on number of end users, duration of trials, set-up,
guidance, payment, etc.) could help here. The same is true of privacy protection. Here also common
standards to fulfill govermmental privacy regulations. (A prototype for privacy protection has been
developed within the Netcarity project, in which Smart Homes is involved.) Finally Ad concluded
that that there are many technical interoperability and standardisation issues that need to be solved.
But also the big number of non-technical issues need at least harmonisation in order to overcome
these non-technical barriers.
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ROADMAPPING/TECHNOLOGY TRENDS IN AAL
Christian Wehrmann
Chair:
Christian Wehrmann (VDI/VDE-IT, AALIANCE Coordinator)
Speakers and Topics
Filippo Cavallo (Researcher, Scuola Superiore Sant'Anna): The AALIANCE Roadmap
Ben Knapp (Head of CAPSIL Executive, Queen's University Belfast): CAPSIL Project
Emilio Mordini (SENIOR Project Coordinator, Centre for Science, Society and
Citizenship): SENIOR Project
Summary
In recent years, the European Commission and European member states have made considerable
investments in ICT and ageing research in the Framework Programme, the AAL Joint Programme
and national initiatives. Similar approaches have emerged in other geographical regions, e.g.,
Australia, Canada, Japan and the United States. Further research needs to build on these results and
be guided by a trends assessment and roadmaps which provide an extended look at the future of
active ageing and ageing well in the information society. This requires co-action between various
technology areas and innovative technology approaches. Information and knowledge about mid/long-term R&D perspectives will be crucial for defining future R&D steps on the way to Ambient
Assisted Living.
Through development of a shared vision and RTD roadmaps by main stakeholders, vital needs not
just for R&D actors but also for other stakeholder will be served. Public Health Authorities can gain
insight in future development affecting their spheres of action, second and third level potential
suppliers for AAL applications can realise challenges ahead. Several ongoing and soon to be
completed FP7 roadmapping projects – AALIANCE, CAPSIL and SENIOR – have addressed
different and complementary perspectives of ICT and ageing.
The AAL Roadmap of the AALIANCE was presented by Filippo Cavallo. AALIANCE – The
European Ambient Assisted Living Innovation Alliance – is a coordination action funded under the
ICT and Ageing theme of the 7th Framework programme. The 2 year project involves 14 members
and more than 20 associated partners from industry, research and user organisations. The
development of an AAL Roadmap is one of the core tasks of the AALIANCE. The first version of
the AALIANCE roadmap was published in August 2009 (available for download on
http://www.aaliance.eu/public/documents/aaliance-roadmap/). In the view of the AALIANCE,
“Ambient Assisted Living” (AAL) denotes concepts, products and services that interlink and
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improve new technologies and social systems, with the aim of enhancing the quality of life for all
people in all stages of their lives. AAL could be translated as “intelligent systems of a specific
assistance for a better and safer life in the home environment”. The AALIANCE roadmap gives a
comprehensive overview of the different applications domains and the enabling technologies
providing the necessary functions, including scenarios and development projections up to 2025.
The roadmap has been discussed with external experts in an evaluation workshop in September
2009. An updated version of the roadmap is planned for 2010. The next step in the AALIANCE
project will focus on identifying and prioritizing the research challenges in the different application
domains and technologies in order to develop a strategic research agenda (SRA) as an action plan
for innovation and research activities in AAL. In the discussion members of the audience expressed
the opinion that in AAL also the user requirement, and not just technological developments
(convergence) as to be considered as a development driver. Filippo Cavallo agreed and explained
that the roadmap aims to give a comprehensive overview of the technological developments and
possibilities. User involvement and user requirements are essential in any R&D efforts, but the
roadmap could not tackle them in full detail. It was also appreciated that the AAL roadmap
addresses the issue of ageing at work.
Another roadmapping effort is done in the CAPSIL project (International Support of a Common
Awareness and Knowledge Platform for Studying and Enabling Independent Living –
www.capsil.org). Ben Knapp explained that CAPSIL is developing a roadmap and Wiki for EU
research to achieve effective and sustainable solutions to independent living based on an in-depth
analysis of clinical requirements and the ICT scenarios developed or under development in the EU,
as well as the US and Japan. The three fundamental objectives are therefore to develop a
consolidated roadmap on ICT for independent living, to gain and share knowledge in this area via a
online wiki and to provide policy makers in the EU, the US and Japan with this knowledge in order
to coordinate research. Part of the project were exploratory mission to the US and Japan to
investigate the current status of AAL technologies in these countries and to meet relevant
stakeholders. Very similar to Europe, most activities in the US concentrate on safety and
health/wellness technologies. Quietcare and Orcatech are examples of companies already active in
the US market. Also serious gaming is becoming more important in the US. In Japan, health and
care policies in recent years are moving from cure focus towards prevention and control. A business
example is the ANZEN Centre focusing on home alarm services. Service and welfare robotics is
highly developed in Japan – several products are already in the market. Analysing the differences in
between the EU, US and Japan it shows, that especially in the reimbursement there are large
differences in care delivery and economic cost distribution. This offers the opportunity to examine
best practices in a foreign context. In terms of technology development the differences between the
3 regions are relatively small. The CAPSIL roadmap and the related wiki currently provides more
than 230 pages with information on the status, visions and gaps in ICT for independent living.
Starting with the situations older people encounter to the preventive measures and interventions that
may be taken, the enabling technologies and issues in the field have been identified in the Wiki.
Here common themes like Body sensor networks, Transportation, Home and mobile monitoring and
the necessary software emerged. In scenarios typical use cases were described and built the basis for
the CAPSIL roadmap. Several gaps were identified in the project. First, a knowledge gap: there is
no easy way to collect comprehensive information on the active stakeholders, requirements,
research and development results in AAL. The CAPSIL seeks to be an answer to this gap.
Furthermore, there is no clear understanding of the relations between the quality of life to be
achieved by AAL, the necessary research and innovation activities and the costs to provide the
technological solutions (and the cost-savings to be achieved after the IT products and services are in
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place). Only future research and larger deployments can provide an answer here. In terms of
technological gaps, CAPSIL has identified the following:
A non-technical roadmap approach is undertaken by the SENIOR project, which was presented by
Emilio Mordini. SENIOR (www.seniorproject.eu) seeks to develop a dialogue roadmap on Social
Ethical and privacy Needs in ICT for Older People. SENIOR is a 24 month support action which
aims to provide a systematic assessment of the social, ethical, and privacy issues involved in ICT
and Ageing, to understand what lessons should be learned from current technological trends, and to
plan strategies for governing future trends. A wide range of ethical and privacy issues have been
analysed based in interaction with more than 50 experts across Europe. Cross-media analysis
examined current understandings of the elderly, the relations between technology & the elderly and
the ethical issues involved. In a socio-anthropological workshop current theoretical and empirical
approaches towards ICT and ageing were discussed. Disengagement theory argues that, as a natural
consequence of ageing, senior citizens wish to withdraw from society and thus become disengaged.
Understanding the meaning of age and ageing requires awareness of the social and cultural context
in which people age. While senior citizens are not necessarily technophobic, they are critical and
selective in their use of computers and the Internet. Access to appropriate training and support is
also a prerequisite for successful use. Monitoring technologies in particular raise ethical questions
concerning privacy and consent. It is important to reach a balance between the pros and the cons of
ICTs for ageing, and this is perhaps best achieved by accommodating the technology to individual
needs. Technology alone will not produce truly innovative or desirable services for senior citizens,
nor will it ensure that senior citizens have equal access to those services. We need better codes of
ethics, standardisation and policies to promote ICT for inclusion. In technology focused working
specific technologies and their potential impact on ethical issues were discussed. Ubiquitous
computing technologies are beginning to become more mainstream, but much of the technology is
still in the laboratory or pilot stage. These technologies can be highly effectively in addressing some
key issues for the elderly, but their use can raise a number of ethical concerns. The hidden nature of
ubiquitous computing solutions can help in overcoming stigmatisation that is often experienced
with assistive devices and technologies. However, this same quality can tend to raise issues with
informed consent, for example, when visitors enter an environment where ubiquitous computing
technology is used. As technology evolves and becomes more broadly available to assist in
monitoring the elderly person, there may be a tendency to implement the technology solution, rather
than thoroughly understanding the needs of the individual. As ubiquitous technologies collect data
through sensors, the individual may be subject to a loss of privacy, and systems need to be designed
to ensure an appropriate level of privacy (i.e., that data is shared only with authorised individuals,
and data is not stored for use beyond purposes agreed to during informed consent discussions).
Effective opt-out capabilities need to be built into those systems. The nature of ubiquitous
communication systems seriously affects notions of autonomy, privacy, informed consent, and
opting-out. If the user has difficultly in understanding the technology, whether because of
unfamiliarity with technical issues, or because of cognitive impairment, there is risk to loss of
autonomy and agency. Key issues in assessing the potential threats to these areas are based largely
in understanding who has access to control the system/devices, who has access to the personal data,
how is data retrieved, interpreted and processed, how is data transmitted and to whom, how and
where data is stored (both on a temporary and permanent basis), how is authority to access granted,
and how informed consent is obtained. The mere existence of a ubiquitous communication system
does not guarantee connection or inclusion. Intelligent user interfaces can make life easier, rather
than to be experienced as a technological burden. Benefits of the use of technology vary
considerably depending upon the individual’s ability and attitude towards human computer
interaction. If an individual does not benefit from the technical solution, non-technical solutions or
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other types of support should be readily available. Safeguards are needed to ensure that the
technical device does not become a substitute for personal contacts. Where older persons, especially
those with hearing or vision impairments or reduced mobility, may be more dependent on systems
than other user groups, and for this group, having effective and available service/support
organisations is crucial. Assistive technologies & robotics raise concerns about autonomous
decision making by robots, about systems for human augmentation and the impact of humanoid
appearance of robotic devices. These Technologies requiring special attention during development,
i.e. in the case of brain-machine interfaces (BMIs) Also of concern are the consequences of
replacing carers with robots and the distress that could be caused by the attachment of the older
people to humanoid or pet robots. There are also a wide range of risks inherent in artificial
intelligence and adaptive software. There is a potential of adaptive software solutions to be
unpredictable and thus unsafe. There is a risk that technology that is adaptive may be difficult to
effectively and thoroughly test. With systems doing advanced decisions making, it could be difficult
to protect an individual’s autonomy and sense of control. It may also be difficult to provide
informed consent for technologies whose behaviours may not be fully predicted. Dependence upon
supportive, intelligent systems may give rise to isolation from human carers and result in isolation –
that is, technology development could become focused upon replacing humans in the care
environment, rather than upon addressing human needs.
In the end, ICT has huge impacts on dignity and non-discrimination of older citizens. Nothing so
clearly violates the dignity of persons as social exclusion that demeans or humiliates them. Put in
positive terms, respect for the intrinsic worth of a person requires a recognition that the person is
always entitled to participate in social and community life notwithstanding her age, disability, and
health conditions. Article 25 of the EU Charter recognizing fundamental rights for the elderly puts
forward the central idea that the elderly have a right “to lead a life of dignity and independence and
to participate in social and cultural life”. Dignity offers clear guidance about the goals that EU
policymaking need to pursue. Older senior citizens are facing the last years of their lives. New
technologies may offer a way to extend their lives in a more comfortable, more dignified condition.
Yet it should be clear that there are some questions concerning life and death that do not allow for a
technical fix. The right to life should never be conceptualised in terms of an obligation to submit to
any anti-ageing technology. In Europe, the digital divide is mostly age-related, which is in open
contradiction with the principles of equality and non-discrimination that are well established in EU
law. According to a consolidated jurisprudence, a difference in treatment constitutes discrimination
either when it lacks “objective and reasonable” justification, or when there is no reasonable
proportionality between the means employed and the legitimate aim sought to be realised. Fair
distribution and inclusiveness in the digital environment are crucial because they are basic good.
Universal access to communication and information services must be recognised as a fundamental
right of senior citizens. We need to understand how ICT may be developed and evaluated by older
people in different cultural contexts and how they can inform technology designers of their needs
and preferences. ICT has also an impact on freedom and autonomy of older citizens. The bodies of
senior citizens are increasingly invaded by micro-technologies, reconstructed as nodes in vast
information networks, and controlled through automated responses or network commands. Privacy
is at the core of the trade-offs that have to be weighed when evaluating the feasibility of deploying
ICT for ageing. In a world where the ability to handle data is rapidly outpacing agreement about
how that ability should be used, the standard approach to privacy is difficult to be applied. For
instance, the EU principles demand that private information may not be required in return for
essential services unless the information is essential for the proper execution of those services, but
would it be possible to make such an evaluation in the field of ICT for Ageing? And other questions
arise: How can one implement the “Individual participation principle” - which states that
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information may not be collected without the explicit informed consent of the individual – in smart
environments? Connectivity and data collection is increasingly default and this poses serious ethical
and privacy problems to ICT for Ageing because older people may be less technologically skilled
and consequently unable to disconnect themselves.
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WORKSHOPS
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WORKSHOP FOR YOUNG RESEARCHERS AND PHD
Ilse Kryspin-Exner
The “Young Researchers and PhD-Workshop” that took place during the AAL-Forum in the Vienna
Hofburg from 30th September to 1st October 2009 was aimed to enhance scientific discussion
among young European scientists concerning the variety of projects dealing with technical solutions
for the elderly. The main objective was to force dialogue between young scientists originating from
different disciplines such as geriatrics, engineering, architecture, informatics, psychology,
sociology, nursing sciences, economics, etc. in order to enrich the scientific spectrum and to offer
the possibility to create networks for gaining new knowledge as well as mutual support, and
furthermore to encourage the participants to initiate future collaborations.
This workshop was especially intended as a kick-off activity for further workshops within the AAL
Forum offering a continuous reflection on the topic and providing the opportunity to report ideas
and progress in work. The installation of an online discussion platform
(http://www.univie.ac.at/aal/), which reaches out beyond the workshop boundaries to appeal to
other young researchers within the EU, was another successful step towards integrating Ambient
Assisted Living research in a multidisciplinary discourse.
The call for poster presentations was met with great response. 33 Posters were presented with more
than 40 young researchers involved. After a “teaser presentation” of the various projects (two slides
each within a maximum of 2 minutes) the participants were divided into 3 groups, each supervised
by a senior scientist. Wolfgang Zagler & Paul Panek (fortec, Technical University of Vienna),
Helmut Hlavacs (Department of Distributed and Multimedia Systems, University of Vienna) and
Ilse Kryspin-Exner (Faculty of Psychology, University of Vienna) gave a short introduction of their
groups and provided assistance during the free poster session which followed the presentations in
the plenum and closed with a plenary discussion and summary.
The first group, which was chaired by Wolfgang Zagler, covered a wide area of research such as the
monitoring of daily living activities and multidisciplinary work as a user interface design for elderly
persons and carers. The focus was on distributed (e.g. 3D surveillance systems) and wearable
approaches (e.g. integrated in shoes) for fall detection and prevention, smart home technology for
AAL (using and integrating existing devices and products including approaches for standardisation)
and self-adapting intelligent systems for monitoring purposes (e.g. developing software agents).
The representatives of this block had a clear technological background, whereas the young
researchers in the second block had scientific origins, AAL & Care, which was supervised by Ilse
Kryspin-Exner and constituted a miscellaneous assembly. The projects referred to tele-monitoring
solutions for Alzheimer and dementia patients, patient-centred ICT support, patient controllers for
deep brain stimulation and Personal Electronic Nursing. The projects of the last block, chaired by
Helmut Hlavacs, focussed on social inclusion and enhancement with presentations with regard to,
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among others, the improvement of social interaction of the elderly, Ambient Assisted Shared
Living, e-mail work flow management of the ageing workforce and mobile phone acceptance by
older people.
Due to the lack of time for discussions the organisers decided to provide the young researchers with
the possibility to meet the following day to discuss possible concerns, pose further questions and
exchange ideas and critique. It was on this occasion that a number of issues were raised among the
participants and senior scientists. One of the greatest concerns relating to the organisational aspects
of the workshop was the often mentioned lack of time for networking and an in-depth discussion of
the matter.
With regard to the content of the poster presentations quite a few questions emerged both during the
power point presentation to the plenum and the free poster survey. Some of them pertained to
research and development in general and put emphasis on the problem of funding and the time
needed for research processes such as the difficulty in finding cooperation partners and cooperating
with diverse disciplines, and hence integrating multidisciplinary approaches. Another issue
discussed particularly in this heterogeneous group of young scientists originating from different
European countries was that of cultural differences which by all means have to be taken into
account when conducting research. Furthermore, the emphasis was put on the problem of already
existing information technology systems and the question, by whom and whether these are actually
used and if, in this case, research in this field should concentrate on the scope of ameliorating
already existing technology. Altogether, the attention of almost all discussions among the
researchers shifted towards the issue of end-user involvement and linked problems such as
assessing the needs, expectations and opinions of the elderly and guaranteeing the compliant
behaviour of an end-user towards assistive technology. There were three main focusses concerning
usability (can we use the new technologies?), usage of new interfaces (do we want them?) and
assistance or unwanted interference.
In future research projects elderly people will be confronted with a plethora of different interfaces,
equipment, and devices. The necessary complexity will present a challenge to the users, especially
concerning fault management.
The questions arose how 1) to design simple user interfaces that do not require any learning efforts,
and 2) to construct fail-safe or self-monitoring and self-repairing systems that do not require
interaction with their users, and yet guarantee to deliver a minimum service even when facing
failure situations.
Further, smart systems that constantly put their users under surveillance might proactively choose
modifications of the living conditions based on system settings and dynamically learned data. In the
extreme case, human living conditions might be totally regulated by machines, and by technology
assistance turning into human independence.
In conclusion, the creative atmosphere of the “Young Researchers and PhD-Workshop” provided an
inspiring outlook for next year’s meeting in Odense and was a unique opportunity to exchange the
concerns, problems and hopes within the field of Ambient Assisted Living solutions for the elderly.
Its apparent success points clearly towards the need to continue such networking and cooperation
and emphasises the desirable goal of allowing this exchange to seize more space and time within the
research and development process.
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THE WORKSHOP ON BUSINESS MODELS
Urs Guggenbühl1 and Chris Flim2
The AAL programme aims to create innovations in the area of ICT for elderly people. This means
that the research and development supported by AAL funds should culminate in a successful
product or service for the elderly within a reasonable time. Success is indicated when end users and
elderly people respectively use this product happily and are even willing to pay money for it. Thus,
it is necessary to look at the market place early on in the project and plan the business side of the
product innovation or service innovation. The instrument for this is called a business plan, which
usually starts with a business idea which looks at the market potential, defines the typical customer
and their requirements, and describes the competition. It looks at the way the innovation can be
communicated and defines the optimal price for the innovation, defines the organisation and
resources needed to develop and to market the innovation, and designs a business model which puts
forward a unique value proposition to the user. The business plan shows the value chain of the
innovation and clarifies how it makes money along the chain, points out the potential and risks
involved in the future, and calculates exactly the capital required to develop and market the
innovation as well as the expected profit and loss statement for the next 5 to 10 years.
For this workshop, we focussed on business models and discussed guidelines which are required to
develop business models for AAL solutions. Experience shows that the focus in AAL projects is
usually much more on the technical development rather than on the market or the user aspect.
However, it is the user who defines the success of the product. A business model looks at the needs
of the market and the user respectively and puts forward a value proposition - a unique offer to the
customer, a value chain which defines the value of a product at each stage in the chain of
development and a process as to how money can be earned, so that the company, which produces
and offers the product, can sustain itself.
By paying more attention to business models, the process of thinking about market readiness is
stimulated from the beginning. However, a business model is a tool, not an objective in itself.
Furthermore, there is no ‘golden standard’ for a business model, but a framework of topics to be
addressed for AAL consortia. A business model itself does not guarantee success. Good business
models may help to make services successful. Bad ones may cause services to fail.
1 Director of the Innovation centre of the University of Applied Sciences, St. Gallen, Switzerland.
2 CEO, Flim P&C, Utrecht, Netherlands.
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Possible practical solutions:
1. The consortia need to ask themselves some specific questions about their business model and
explicitly provide argumentation to endorse their answers.
• Who are the target groups? What needs do they have? How can they be addressed?
• How do the products/services fulfill the needs of the target groups?
• Who will pay for the products/services?
• Who will deliver the products/services?
• Analysis of the flow of costs vs. benefits.
• Who will carry out the maintenance of the products/services?
• Who are the stakeholders?
• What are the specific areas of attention with regard to different countries/regions?
• Which partners to choose in order to develop, implement and exploit determined products and
services?
• What's in it for all the stakeholders, (Business Case - macro and per stakeholder); separated into
medical, economical and social aspects.
2. The AAL JP needs to provide more guidance to both the consortia and evaluators to set up and
evaluate a (good) business model.
The consortia should provide good argumentation for their answers. Evaluators should not take the
answers for granted, but should be able to judge the proposals on the substance of the arguments.
For many people involved, (especially from a R&D background) business models are a new
territory through which they should be guided. The way in which both consortia and evaluators are
helped to answer and to evaluate the questions is important. The relevant background information
should be provided on the AAL website.
3. The key question is who will pay for the actual product/service when it reaches the market?
Although there are differences within European countries, there are similarities as well. It can be
useful to provide some background on the key motivations, for example, for elderly people,
healthcare insurers and social institutions etc. to pay for AAL services. What’s in it for them? At a
later stage, it might be an option to go into more detail for the specific AAL member states. The
answers to these questions should guide the development process of services.
From the outset as well as for the whole duration of the project, the end users and those who pay
should be involved as a matter of common practice. They must be continually asked at different
stages in the project, if they are still willing to pay for the AAL product/service which is being
developed.
Another aspect that might be useful for the consortia, is a generic overview of the reimbursement
systems for health and wellness-related services as per each AAL country e.g. the comment made
by Laszlo Meleg on the Hungarian situation
• The health market (including the tele-health and AAL) is not a regular market, at least not in
Hungary. Almost the whole market depends on the reimbursement system. And within this irregular
market, the patient does not care and usually has no knowledge of the costs. The decisions are not
made by the patient. Most of the patients will not or cannot pay for any health service not covered
by the reimbursement system. The purchaser (The National Health Insurance Fund) will pay, but it
has very little influence on the purchasing and therapeutic decisions. In each case, the physician
concerned will decide which device is to be used, but he/she does not care about the costs, as he/she
has to choose the "best available treatment" according to the Hippocratic Oath. The suppliers of
medical devices are able to sell within this reimbursement system, and, because they want to sell,
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they have to convince the physicians to use their specific products. (The situation is very similar to
the marketing of drugs, but without a comparably strict pre-market evaluation).
• Actually, the AAL market is similar to the video-recorder market before the VHS-system won,
or marketing high-capacity DVD type storage media while blue-ray and the HD-DVD were in
competition. Everyone is waiting for a winner. This market can start to grow as soon as
compatibility can be assured. One possibility is to wait for a winner, but most probably, from a
technical point of view, not the best system will win and the process will just continue. Another
possibility is to help this process along by means of an actively developed protocol, which is freely
available, and by persuading the main purchasers to necessitate compatibility.
• Competition can be reinforced by creating some freely available data centre software with very
basic functionality to initiate the usage of the AAL systems.
• Many AAL systems and many aspects of them can also be used in the field of fitness/wellness
which is closer to the regular market. At first, these systems/parts could be launched onto the
market which would then also help to increase acceptance by elderly people.
4. Market research: Do we build upon the shoulders of others?
The consortia must do real market research. It is important, for example, that the consortium knows
about all other R&D activities on their subject so that they can build on it. To guarantee success, the
consortia should list at least three R&D activities on which they could build. Also, a short
competitor analysis should be added which lists the products and services available on the market
that aim to serve the same needs for elderly people as the planned service or product which the
consortia want to develop. Finally, some argumentation should be presented (based on market
research) to demonstrate that a market opportunity exists for the proposed AAL service(s).
5. Changing roles of consortia partners
What is the role of all partners during the process from the start of a project to the market launch?
These roles will change. Some partners may even leave after a certain period. Some new partners
may become involved. Who will be the organisation introducing the service to market? Who will
finance the product launch and develop the product further? Who will maintain the service etc? This
is a paradigm shift in the way proposals are usually written for European R&D projects. However,
this is precisely what AAL is aiming for. It also raises the question as to who the main target group
is that the calls want to address. For example, how can the call interest SME’s and how can the call
make them the frontrunners for the proposal?
6. Change the order of the criteria in the Call
The order of the four criteria should be changed by starting with the end users and their needs, and
the proposed service and underlying business model. Answering these questions should cover the
main part of the proposal. Then the scientific value and societal relevance can be briefly addressed
as providing scientific evidence is difficult anyway. What are you trying to prove and for whom? Is
it scientific or medical evidence? Is it social evidence or economic evidence? Whom is one trying to
convince? The question cannot be whether or not there is enough scientific evidence but, rather, is
there a market for the services and products?
A practical example from the Netherlands put forward by Chris Flim (for more information please
contact the Netherlands Ministry of Health or Syntens.)
The Ministry of Health initiated a new programme together with Syntens, a non-profit organisation
closely related to the Ministry of Economic Affairs, focussing on innovation through SME’s in all
market sectors. The project is called “Small-scale living for elderly people with smart housing or
personal services”. The project uses some of the objectives which are familiar to the AAL selection
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criteria such as 50% of their own budget and a number of SME’s must be involved, etc. However,
the budget (partly earmarked, partly free to spend for specific objectives) is not spent on
development, tests or pilot projects. The solution is expected to be close to market and the consortia
will receive help in how to prepare for the market and how to scale up. Topics that are to be
financially supported focus on economic and organisational questions like the business model,
business case, target audiences and their needs plus reimbursement schemes and setting up the
consortium to deliver the service (and develop it further). Attention will also be paid to ICT aspects.
Open standards and interoperability should be guaranteed and should be decided by the
organisations involved and not the suppliers of ICT in order to prevent customer lock in. This
approach may not be fit-for-use to AAL as a whole, because no new solutions should be developed,
but new services should be brought to market. However, one suggestion that could be implemented
for AAL projects is to earmark a specific budget per project to invest in economic and
organisational aspects.
It is important that the AAL JP finds ways and means to get the consortia to focus on the business
aspects of the AAL solutions. Some ideas on how to do this have been put forward in this summary.
It is also very important that we keep up the dialogue within the AAL community and together try
to find ways and means to make AAL solutions successful on the market.
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ARTICLES
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PROGRAMME BENEFIT:
PUBLIC FUNDING IN THE THEMATIC AREA OF AAL IN
AUSTRIA
Gerda Geyer1 and Kerstin Zimmermann2
The programme benefit is the first Austrian mission-oriented thematic programme in the field of
ICT. The programme was set up in 2007 as the national backbone programme for the Austrian
participation in the Article 169-Initiative Ambient Assisted Living Joint Programme (AAL JP). The
initial phase of the programme was dominated by activities to build up the community and create a
common understanding and common knowledge base. The first calls focused on “ICT-based
Solutions for the Advancement of Active Ageing”.
1. Introduction
The programme benefit is a new mission-oriented R&D programme launched by the Federal
Ministry of Transport, Innovation and Technology (Bundesministerium für Verkehr, Innovation
und Technologie, BMVIT) in November 2007. The programme was established as an Austrian
backbone programme for the participation in the AAL JP. The funding programme was planned and
prepared by the BMVIT together with the Austrian Research Promotion Agency (Österreichische
Forschungsförderungsgesellschaft, FFG) which is in charge of the programme management.
The funding is based on the directive for research, technology and development (FTE-Richtlinie,
BMVIT, BMWA 2007) in accordance with EU laws3.
2. The Programme benefit – General Aspects
Under the headline “Demographic Change Perceived as a Possibility,” the programme fosters
research and development activities for ICT-based products and services enhancing the quality of
life of older persons. Older adults shall be supported in living autonomously and as long as possible
at home. In order to reach this goal, new business models, marketing concepts and value chains
shall be stimulated.
1 Dr. Gerda Geyer, Austrian Research Promotion Agency, programme manager of programme benefit and National
Contact Point for the Austrian participation in the AAL JP.
2 Dipl. Ing. Kerstin Zimmermann, Federal Ministry of Transport, Innovation and Technology, Scientific Policy Officer
for benefit and AAL.
3 BMVIT, BMWA 2007: Richtlinien zur Förderung der wirtschaftlich-technischen Forschung und
Technologieentwicklung.
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Further aims of the programme benefit4 are:
• Improving the competitiveness and networking of Austrian research, economy and social
and health care service institutions within the thematic focus of the programme, through
cooperation and involving end-users, also in the international context;
• Training highly qualified researchers;
• Improving the usability of developed, innovative ICT based products and services for endusers;
• Improving the acceptance of Ambient Assisted Living.
The programme benefit fosters innovation and application oriented projects in cooperation between
enterprises, institutions providing health and social care services as well as end-users (primary,
secondary, tertiary end-users) and research organisations.
The types of funded projects are:
• Cooperative projects between two or more enterprises or one or more enterprise(s) and one
or more research institution(s);
• Stimulation projects (workshops, conferences, studies etc.);
• Human resources projects (scholarships for doctoral students etc.).
The time-to-market perspective of the projects ranges between one and three years.
Stimulation projects and human resources projects can permanently be submitted in the so-called
Open Call.
3. Focus on: ICT-based Solutions for Advancement of Active Ageing
When the first call of programme benefit was launched in November 2007, the overall conception
of ICT-based solutions for enhancing the quality of life of older adults was mostly associated to
health issues. Yet in the initial phase of the programme benefit programme-owner BMVIT and
programme-management FFG agreed to focus on “ICT-based Solutions for Advancement of Active
Ageing”.
The decision was based on the following rationale:
- most older adults enjoy quite a good state of health (the large group of the independent
performers, so-called go-goes) and
- are willing to pay for useful and easy-to-handle-products,
- whereas most older adults in Austria who are supported retirees (no-goes) are not able or
willing to pay for additional products and services5.
The decision was also supported by the facts that
- the percentage of ICT-use among older adults is still very low when compared to other age
groups and
- older adults who are not digitally literate run a higher risk of feeling and being excluded
from society.
4 BMVIT 2008: Programm-Dokument benefit.
5 Innovendo: SOPAAL – Feasibility Study on Socio-economic Parameters to Support a National Implementation of
AAL in Austria. Vienna, July 2007.
112
Similar to the WHO definition of active ageing, the Austrian programme benefit defines active
ageing as a process enhancing the quality of life of individuals by reaching the maximum access to
participation / social integration, security and health.
Thematic clusters within that focus are:
• Social inclusion (e.g. including information, creation of networks);
• Activities within and outside the home environment (including tourism, fitness etc.);
• Comfort and security (e.g. including smart homes, measuring vital parameters).
The main target group in terms of primary end-users of products and services to be developed in
projects funded by the programme benefit is the large group of older persons in (relatively) good
mental and physical health who have a more or less active lifestyle. Focussing on active ageing is
deemed to be promising for the programme benefit. Business cases for the mostly self-deciding,
active older persons are easier to establish than for other segments of older persons. This should
encourage industry to target this new market. It is assumed that people are willing to pay for useful
products and services which really meet their needs and enhance their lives.
Thus people can befriend technologies even though they do not need them, but use them for their
fun and for comfort reasons. This could prove to be beneficial to persons who face major limitations
to their mobility etc.
Meeting real customers’ needs, targeting an appropriate market segment as well as the usability and
the design of products are important success factors when addressing older persons. In order to
increase the project’s chances to really meet the needs of the target group, it is highly recommended
to integrate end-users in the projects. End-users who act as project partners are usually secondary or
tertiary end-users and not the older persons themselves. Older persons are normally not integrated
in projects as partners but as persons who support and provide input to a project by giving
interviews, making observations and/or testing prototypes.
4. Building up the Community
Before launching the programme benefit, there was already a heterogeneous ICT-related research
community in Austria focussing on usability, visual detection and telecommunication. Some of
those activities were performed by high potential SMEs. As there was no dedicated funding
instrument and the market sector for older adults is regarded to be complicated, activities remained
scarce and scattered.
Contrary to the ICT-situation, basic research in the fields of geriatrics and gerontology has quite a
long tradition in Austria6. In this respect, the potential for interdisciplinary collaboration was
promising.
A new target group for the R&D programme were the so-called “Daseinsvorsorger” which
according to the rationale of the programme are defined as institutions providing social and health
care services to older persons. As those institutions have contact to the primary target group and are
aware of many of their needs, they are important potential partners in projects.
6 Geyer, Gerda: Alternsforschung in Österreich. Entwicklung, Institutionalisierungsgrad, Forschungsförderung. Wien,
WUV, 2008.
113
In order to take pre-exisiting experiences and knowledge into account as well as to endorse
networking, programme-management put a focus on community building by designing and
organising different kinds of meetings and events. Several “Experts Consultations” were held
before launching the first calls. Outcomes of the consultations were integrated in the call
documents. Presentations and networking activities related to expert consultations and launch
events endorsed the knowledge transfer, new cooperations and new contacts among the (potential)
community.
The community was strongly encouraged to submit proposals which aim at holding conferences and
workshops as well as human resource projects for giving young researchers the means to investigate
relevant topics.
The programme-management also commissioned a study to investigate perceptions of selected
“experts from practice” and to identify essential aspects of the context to be considered by the
programme benefit. The study aimed at identifying important actor groups and the relevant topics
according to their perceptions.7
5. Evaluation Criteria and Process
The whole evaluation process is organised, prepared and chaired by the programme-management.
Normally, the evaluation process is concluded four to six weeks after the deadline for submission.
Typically, each proposal submitted in programme benefit is evaluated independently by at least
three national or international experts. After completing the independent evaluation process the
evaluators attend a panel meeting. In the panel meeting each proposal is discussed. Finally the
evaluators give a common and normally unanimous recommendation for funding or not funding the
discussed project.
The programme owner BMVIT is also present at the panel meeting. The outcome of the panel
meeting is the ranking list which the evaluators propose to the programme owner. The formal
decision on funding projects has to be taken by the Ministry on the basis of the recommendation
given by the experts8.
The evaluation criteria for cooperative projects are as follows:
Quality of the proposed activity
• Technical and scientific quality / innovation
• Technical and scientific challenge, methods and dissemination
• Project management and resources
Relevance of the proposed activity: contribution to the aims of the programme
• Improvement of usability
• End-user involvement
• Ethical aspects
• Inter- and transdisciplinarity
7 Institute of Technology Assessment of the Austrian Academy of Sciences: Participatory Approaches for Technology
and Autonomous Living. Vienna, May 2008.
8 Find more information on the evaluation process in the Evaluation Manual (Bewertungshandbuch) on
http://www.ffg.at/content.php?cid=747.
114
•
R&D aspects
Suitability of applicants / partners
• Enterprises, social and health care providers (including end-users organisations)
• Research partners
• Consortium & cooperation partners
Economic potential and exploitation
• Market prospects
• Exploitation
Ethical aspects
Each benefit project which is submitted in a fix call will undergo an assessment of ethical aspects
during the evaluation process. Ethical aspects include the way end-users are involved in a single
project as well as ethical aspects of the project’s idea.
Integrating end-users into projects gives rise to very practical ethical issues. Whenever end-users
are involved in a benefit project in interviews, observations, and/or testing of prototypes they must
be aware of the implications they are signing up for. Transparency is the keyword.
From the third call for proposals, the submission of a draft version of the “informed consent” has
become a prerequisite in programme benefit when primary end-users are involved in a project.
6. Funded Projects in Programme benefit
In 2008 and 2009 a total of 66 projects were submitted, 37 of which have been funded. The success
rate in the programme benefit is 56%. 16 out of the 37 successful projects are cooperative projects9.
The total funding budget amounts to about five million euros.
FFG: Funded Projects 2008-2009 in Programme benefit
Call
Number of funded projects
Open Call 2008
Second Call 2008
Third Call 2008
Open Call 2009
Fourth Call 2009
Fifth Call 2009
Total Number
7
6
8
2
6
8
37
Number of funded
Coop. Projects
/
2
5
/
5
5
16
7. Conclusions and Outlook
The first calls launched in programme benefit showed that the Austrian potential in this thematic
area is high. The community seems to be well aware of the necessity of interdisciplinary and
9 Find a compilation of funded benefit projects on http://www.ffg.at/content.php?cid=1066.
115
transdisciplinary cooperation. Some projects are very promising for what is regarded to be a quick
entrance in the market after the project’s end. Others are addressing very interesting aspects with
respect to usability and smart home applications.
In the working programme for 2010, programme management focuses on
• continuing to put measures into place for building up the community,
• spreading interdisciplinary and transdisciplinary knowledge among the community,
• consolidating knowledge which has already been gained and
• including an additional thematic cluster within the focus of the call which will be launched
in 2010.
116
THE LIVING SITUATION OF OLDER PEOPLE IN
AUSTRIA COMPARED TO OTHER EUROPEAN
COUNTRIES
Isabella Buber1
Europe’s population is becoming older and older and population projections predict that in 2050
about half of the EU-15’s population will be aged 50 or above (Scherbov and Mamolo 2006). In
view of such an important shift in the composition of the population, analyses on individual life
circumstances of the growing group of older persons in Europe are highly relevant. The current
paper is based on the “Survey of Health, Ageing and Retirement in Europe” (SHARE), a European
dataset that includes accurate cross-national information on economic circumstances, health, wellbeing, integration into family and social networks. Living conditions of older people in Austria
compared to other European Countries are presented, including family status, children and
housing. As a financial indicator, the subjective assessment of the economic situation of the
household is presented for Austria as well as the other 10 European countries included in SHARE.
Another main aspect of ageing is health, focusing here on self perceived health and limitations in
the “Activities of Daily Living” (ADL). Finally, different aspects of social participation of the
population aged 50 years are presented, like voluntary work or participation in a sport or other
kind of club.
In 2008, Austria comprised 8.3 million inhabitants and these can be divided in three general groups:
Children and adolescents, the potential labour force and old or retired persons. Traditionally, the
cutting ages have been at 15 and 60 years, but ages 20 and 65 are more and more used for dividing
populations and calculating dependency ratios. According to this grouping, today 17 % of the
Austrian population are aged 65 years and more, 21 % are children or adolescents and 62 % belong
to the potential labour force. Projections by Statistics Austria predict that the Austrian population in
2050 will have the following structure: About 28 % will be aged 65 and more, 18 % will be under
the age of 20 and only 54 % will belong to the potential labour force. The projected structure of our
society and the increasing relative size of older persons will represent a challenge for financing our
health and pension system. Moreover, it constitutes a challenge for applied research and industry to
develop instruments, tools and products that alleviate every day living of older persons and enables
them to age in place.
The structure of a population and its dynamics is determined by fertility, mortality and migration.
Only these three factors influence the shape of the age pyramid and the structure of our society. A
comparison of France and Italy, two European countries with similar societies but different fertility
1 Vienna Institute of Demography, Austrian Academy of Sciences; Wohllebengasse 12-14, 1040 Wien;
[email protected].
117
rates reveals that the French society will be much more balanced compared to the Italian population
in 2050, if the traditionally high fertility rates in France and the low levels of fertility in Italy pertain
for the next decades. Migration is doubtlessly the most uncertain determinant for population
dynamics, and also most difficult to forecast. In its projections, Statistics Austria assumes migration
to decrease from currently 115.000 persons per year to 100.000 persons in 2020. Migration is
determined to a great extent by political decisions and the economic situation within a country as
well as by the political and economic circumstances in the countries of origin. The most recent
economic development and the political changes after the fall of the iron curtain show that it is
more or less impossible to anticipate the future development of migration.
One of the main indicators for mortality – the third determinant for shaping the age structure of a
society – is life expectancy. Austria, together with the other Western European countries, has
witnessed a steady increase in life expectancy. A boy born today has a high chance to celebrate his
76th birthday, and a girl even her 83rd one. Today, persons aged 60 years, can expect to live on for
about 23 more years. The continuation of life expectancy increases throughout the 20th century was
unanticipated by demographers and the pace of increase in life expectancy has not slowed down
over the last half century. Although with some controversies, there is consensus among
demographers that we have little reason to expect a generalised slowdown in the near future. Jim
Vaupel, one of the directors of the Max Planck Institute for Demographic Research in Rostock
states for Germany: “We should not assume to remain under the 90-year threshold until 2050.”
In view of the increasing life expectancy, the question arises if this gain in life expectancy means a
longer life in good health or in bad health. An appropriate approach is the concept of “disabilityfree life expectancy”. It is based on self-perceived health and takes into consideration chronic
diseases and impairments in activities of daily living, like bathing/showering, dressing, eating or
using the toilet. Comparing Austrian health surveys carried out during the last 15 years indicates
that the share of time spent in good health increased for men and for women. This can be
interpreted as compression of morbidity which goes in line with findings for Germany. The
calculations also show a characteristic of the ageing process in Austria: At higher ages, we observe
frail women and dead men.
In view of such an important shift in the composition of the population, comparable data on
individual life circumstances for the growing group of elderly persons are needed. The “Survey of
Health, Ageing and Retirement in Europe” (SHARE) is the first European dataset that includes data
on individual life circumstances for the growing group of older persons in Europe. SHARE was
created to follow the English Longitudinal Survey of Ageing (ELSA) and the American Health and
Retirement Survey (HRS). Understanding ageing and how it affects individuals in the diverse
cultural settings of Europe is the main task of SHARE (Börsch-Supan et al. 2005). SHARE is a
multidisciplinary enterprise with a strong emphasis on economics, health, and social networks. The
data include accurate cross-national information on economic circumstances, health, well-being and
integration into family and social networks for the following twelve countries: Austria, Belgium,
Denmark, France, Germany, Greece, Israel, Italy, the Netherlands, Spain, Sweden and Switzerland.
SHARE is designed as a longitudinal dataset with a biennial survey schedule. The first wave of data
collection was carried out between 2004 and 2006, the second wave in 2006/07 and the third in
2008/09. SHARE expanded and the second wave included three new accession countries, namely
Ireland, Poland and the Czech Republic.
The current study is based on data of the first wave and covers 27.320 individuals aged 50 years and
more in the eleven European SHARE-countries. We do not include Israel in this study. For more
118
detailed information on results for the Austrian GGS we refer to Buber (2007), Buber et al. (2006).
The following country codes are used in the figures: AT=Austria, BE=Belgium, CH=Switzerland,
DK=Denmark, ES=Spain, FR=France, GE=Germany, GR=Greece, IT=Italy, NE=Netherlands,
SE=Sweden.
The paper focuses on living conditions of older people in Austria and compares them to other
European Countries. The SHARE Austrian sample comprises 1.839 men and women aged 50 years
and more. For analyzing the partner status, persons living with a partner were considered as one
group, irrespective of their marital status, therefore including married and cohabiting couples like
widowed and divorced persons who were living with a partner at the time of the interview. Nearly
three out of four respondents aged 50 to 59 were living with a partner, this proportion decreased to
one out of four among persons aged 80 and more.
90
80
70
60
partner
50
widowed
40
divorced
never married
30
20
10
0
50-59
60-69
70-79
80+
50-59
men
60-69
70-79
80+
women
Figure 1: Partner status of older persons in Austria
Source: SHARE 2004 Release 2.0.1, weighted data, authors’ own calculations.
The partner status of Austrian elderly shows striking differences by sex (figure 1). Especially at
higher ages, i.e. 70 years and above, the percentage of widowed persons is much higher among
women as compared to men. In the age group 70 to 79 years, 16% of Austrian men and 53% of
Austrian women were widowed (and living without a partner); among the interviewed persons aged
80 and above, 37% of the men and three out of four women were widowed. The main reasons for
these findings are women’s higher life expectancy and losses during World War II. The gender
differences in partner status are observed in all countries included in SHARE.
For older persons, children, proximity to children and relations to children are a crucial aspect. In
the SHARE sample, between 10 and 15 per cent of all respondents had no child or stepchild. The
availability of kin support largely depends on geographic accessibility and social contact. It is
therefore important to have information on these two dimensions of parent-child relations.
Regarding geographical proximity, the variation in the number of older persons living sharing the
119
same household with a child is astonishing (figure 2). In the Mediterranean countries, co-residence
and thus daily contacts form the dominant pattern of parent-child relations. In Italy, Greece and
Spain, about 50 percent of older persons interviewed in SHARE were living with a child in the
same household or building. Co-residence is rare in the northern countries, Austria lies in between.
About 30% of the Austrian respondents were co-residing with a child.
60
50
40
30
20
10
0
AT
DE
SE
NL
ES
IT
FR
childless
same household/building
distance 25 to 100 km
distance more than 100 km
DK
GR
CH
BE
distance less than 25 km
Figure 2: Proximity to children
Source: SHARE 2004 Release 2.0.1, weighted data, authors’ own calculations.
The SHARE data confirm, on the one hand, the existence of longstanding regional patters of
“weak” and “strong” family ties, while, on the other hand, they reveal many similarities across
Europe. In all countries 75% of all parents have at least one child living at a distance of at most 25
km. Moreover, the share of parents with less than weekly contact to a child is equally low (7%).
A further aspect of the living conditions is the ownership of one’s dwelling, which is part of the real
assets and hence of the wealth of the household. In all countries about 50% or more of the
respondents own their dwelling. This percentage is especially high in the southern European
countries (over 80% in Spain and Greece, 76% in Italy). Roughly every second Austrian person
interviewed in SHARE owned his or her house or apartment. Dwelling owners prevail among the
younger age groups. However the differences across age groups are small in southern Europe and
large elsewhere, especially in Denmark, Sweden, the Netherlands, Austria, Germany and
Switzerland. In Austria, about six out of ten persons aged 50 to 69 years owned their dwelling,
compared to 35% among those aged 80 years and more. The regularity might be explained by the
fact that older people transfer their houses to their children or sell them and move to live as tenants
in smaller dwellings.
Further aspects of housing included in SHARE concerned the size of residences, the number of
steps to the entrance, the amount of rent payments, or the ownership of further properties like
houses, land or forest. Moreover, individuals were asked for special features that assist persons who
120
have physical impairments of health problems. In Austria, 6% or respondents aged 50 years and
more had any kind of features that assist impaired or ill persons, whereas such tools or products
where much more common in Sweden, Denmark and the Netherlands (12-17%). As expected, the
availability of these features are associated with age and mostly mentioned among persons aged 80
years and more. Moreover, residential mobility is captured in SHARE with asking for the duration
of stay in the present accommodation. It turned out that Austrians and persons in the Mediterranean
countries are the least mobile, since there the mean number of years living in the current
accommodation are highest for all age groups.
SHARE includes very detailed information on the financial situation, like labour earnings, rent
payments, imputed rents received from housing properties or capital income like bonds, stocks or
interests from bank accounts. Moreover, respondents were asked about their subjective assessment
of the economic situation. Perceived income adequacy is a useful indicator part of one’s economic
well-being and an especially important indicator for understanding the financial capacities of older
people. The self-rated economic status is a robust indicator of financial capacity in older age and
can be used by practitioners to gain meaningful information (Litwin and Sapir 2009). Fortunately,
Austria is among the country with comparable low levels of financial constraints among older
persons. Roughly three out of ten persons aged 50 years and more mention difficulties to make ends
meet, compared to 50% to 70% in Greece, Italy and Spain. Although the subjective assessment of
the own economic situation is comparable good, it has to be stated that older persons indicating a
tight financial situation are a non-negligible group in Austria. Analyses by Litwin and Sapir (2009)
suggest that the oldest-old may underestimate financial difficulties, eventually leading to an ever
higher proportion of persons aged 80 years and more with financial difficulties.
Certainly, health is one of the main aspects of ageing and the collected accurate information on
physical health comprises a broad range of different health measures, like self-reported general
health, self-reported diagnosed chronic conditions or medications, symptoms as well as ADL
limitations or IADL limitations. Further aspects of health, such as mental health, physical
measurements (hand grip strength and gait speed), body mass index (BMI) and health care are also
covered in detail.
Self-reports of general health have proved to be useful indicators of an individual’s health.
Respondents have been asked how they rate their general health on a 5-step scale ranging from
“very good” to “very bad”. Concentrating on those who rate their health as less than good, between
20% (in Switzerland) and 52% (in Italy) of persons aged 50 years and more perceive their health as
less than good (figure 3). Except for France, the findings reflect that men report better health, but
have lower life expectancy than women (Case and Paxson 2005). Although self-reported health is
an essential indicator, it is a subjective measure and might reflect cultural differences. Although
being a subjective measure, and biased to some extent by cultural differences, it has to be stressed
that self-assessed health is a valuable indicator for true health. Moreover, the personal component of
this measure is valuable, because it not only important how physicians evaluate a person’s health, it
is also crucial for an individual how healthy she/he feels.
121
100
80
60
40
20
0
IT
DE
GR
ES
AT
50-59
FR
60-69
SE
70-79
DK
BE
NL
CH
80+
Figure 3: Self perceived health, proportion of persons with “less than good health”
Source: SHARE 2004 Release 2.0.1, weighted data, authors’ own calculations.
An important dimension of health refers to limitations regarding the ability to engage in the typical
physical activities of daily life, more exactly “Activities of Daily Living” (ADL) — which include
dressing, getting in and out of bed, eating, etc. Physical functioning reflects the ability of
individuals to perform normally in society and to manage everyday living, and older adults who
have difficulty with ADLs often require personal assistance from relatives, friends, or neighbors to
carry out these important tasks, or are possible consumers of products enabling to support daily life.
ADL limitations are highest in Belgium, Spain, Italy and France with a level of 13% among persons
aged 50 years and more, and - with the exception of France - men claim less often to face
limitations than women. Austria is in the group with comparable low levels of such limitations in
the interviewed sample. The proportion of people with at least one ADL limitation grows with age:
whereas Austrians aged 50 to 69 rarely report ADL limitations (6%), the proportion of those with
functional limitations raises to 11% among persons in their seventies and to 29% for interviewed
men and women aged 80 years and more.
Finally, different aspects of social participation of the population 50+ are presented, which are
included in SHARE and constitute another aspect of living conditions of older persons. Leisure
activities and engagement in productive activities require mental effort and are cognitively
stimulating and may be important in maintaining cognitive vitality in old age and ageing in place.
Activities in retirement might compensate the loss of previous active roles and are an important
aspect of social integration. Social involvement and avoidance of social isolation most likely
challenge individuals to communicate and participate in exchanges that stimulate cognitive
capacities (Berkman et al. 2000) and enhances cognitive functions (Engelhardt et al, forthcoming).
Numerous older Europeans are engaged in a variety of productive activities beyond gainful
employment. On average, over the last month preceding the SHARE interview, 11% of Europe’s
122
generation 50+ performed volunteer work, 18% went to a sport, social or other club, 19% provided
help to family, friends or neighbours, 5% cared for sick or disabled persons. The share of older
persons attending educational or training courses or participation in a political or community
organisation are low (5% and 4% respectively).
Participation varies substantially between countries. In general, the largest proportions of active
elders are found in the Scandinavian countries, the lowest in the Mediterranean countries. Austria
takes a position in between with 9% of older persons reporting volunteer work within the last
month, 15% going to a sort, social or other kind of club, 22% participating in a religious
organisation and 6% participation in a political organisation.
Table 1: Different types of social involvement by country
AT
Voluntary or charity
work
9
Cared for sick or
disabled
7
Help
to
family,
friends, neighbors
23
Educational
or
training course
4
Sport, social or other
kind of club
15
Participation
in
religious organisation 22
Participation
in
political organisation
6
DE
SE
NL
ES
IT
FE
DK GR
CH
BE
ALL
11
19
22
3
8
15
19
3
16
17
11
6
8
8
3
3
7
6
5
8
9
5
17
42
31
6
13
27
35
16
22
30
19
6
14
8
2
1
4
11
4
18
10
5
26
26
30
7
7
19
32
6
35
22
18
10
6
11
11
5
5
5
37
12
7
9
4
5
3
2
2
4
5
5
8
7
4
Source: SHARE 2004 Release 2.0.1, weighted data, authors’ own calculations.
Acknowledgements
SHARE data collection was funded primarily by the European Commission through the 5th
Framework Research and Development Programme (project QLK6-CT-2001-00360 in the thematic
programme Quality of Life). Additional funding came from the United States National Institute on
Aging (NIA) (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, Y1-AG-455301 and OGHA 04-064). Data collection in Austria (through the Austrian Science Foundation, FWF,
grant number P-15422), Belgium (through the Belgian Science Policy Office) and Switzerland
(through BBW/OFES/UFES) was nationally funded. The SHARE data collection in Israel was
funded by NIA (R21 AG025169), by the German-Israeli Foundation for Scientific Research and
Development (G.I.F) and by the National Insurance Institute of Israel. Further support by the
European Commission through the 6th Framework Programme (projects SHARE-I3, RII-CT-2006062193 and COMPARE, 028857) is gratefully acknowledged.
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Börsch-Supan, A., A. Brugiavini, H. Jürges, J. Mackenbach, J. Siegrist, and G. Weber (eds.) (2005) Health, Ageing and
Retirement in Europe – First Results from the Survey of Health, Ageing and Retirement in Europe. Mannheim: MEA
Eigenverlag.
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with special focus on aspects of health. Vienna Yearbook of Population Research 2007: 309-326.
Case, A. and C. Paxson (2005) Sex differences in morbidity and mortality. Demography 42: 189-214.
Engelhardt, H., I. Buber, V. Skirbekk and A. Prskawetz (forthcoming) Social engagement, behavioural risks and
cognitive functioning among the aged. Ageing & Society.
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Survey of Health, Ageing, and Retirement in Europe. The Gerontologist 49(3): 397-406.
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124
OVERVIEW OF THE EUROPEAN STRATEGY IN ICT
FOR AGEING WELL
EU Commission
1. Why is ICT for Ageing Well important?
The number of people over 50 will rise by 35% between 2005 and 2050. The number of people over
85 will triple by 2050. Recent OECD analyses forecast escalating costs as a result of ageing
populations in Japan, the US and Europe. As fertility rates are also declining, the ratio between
people at work and remaining population will change from 4-1 today to 2-1 by 2050 in average in
Europe!
Without a higher level of participation of the elder population in employment, and without better
tailored and more effective health and social care services, these trends will put serious pressure on
Europe's social models and public finances.
OECD Forcast - Coping w ith an ageing population: the extra cost of healthcare,
long-term care and pensions (from 2005 levels, in percentage points of GDP)
0,00% 2,00% 4,00% 6,00% 8,00% 10,00% 12,00% 14,00% 16,00%
Eurozone
France
Germany
Italy
Spain
2025
Sweden
2050
UK
US
Japan
Canada
The total number of frail and disabled persons is likely to rise in the future because of Europe’s
rising ageing population. The OECD predicts for instance, that by 2020, the number of older people
living in institutions will have increased by 74% in Japan, 61% in Canada, 33% in the US, 26% in
Germany, 29% in France, 27% in Sweden and 18% in the UK. (Source: OECD).
The numbers of disabled people living at home are also set to grow fast. Between 2000 and 2020
they are expected to rise by 74% in Japan, 62% in Canada, 54% in France, 41% in the US and 29%
in Sweden (source: Senior Watch study - www.seniorwatch.eu).
125
Although the older age group is not a homogenous one in terms of education, income, or even the
types of disabilities often associated with age, older people as a group are at the greatest risk of
being excluded from the benefits of the Information Society. A recent study, for example, found
that more than 60% of persons over 50 in Europe feel that their needs are not adequately addressed
by current ICT equipment and services.
2. What can Information and Communication Technologies contribute to
Ageing Well?
ICT can help elderly individuals to improve their quality of life, stay healthier, live independently
for longer, and counteract reduced capabilities which are more prevalent with age. ICT can enable
them to remain active at work or in their community.
Independent living is the ability for older people to manage their life styles in their preferred
environment, maintaining a high degree of independence and autonomy, enhancing their mobility
and quality of life, improving their access to age-friendly ICTs and personalised integrated social
and health care services. Ageing well is also about continued active and satisfying participation in
social life and work, when ageing.
In addition ICT can help to improve the working conditions for people working in the care sector
and as such help to make care work more attractive in the future, where there will be much greater
competition for the available workforce.
ICT Solutions address daily and independent living such as:
- Social communication: easy access to phone and video conversation, notably if enabled by
broadband to stay in touch with family and friends, overcoming social isolation (in several countries
over half of the 65+ are living alone),
- Daily shopping, travel, social life, public services: easy access over the internet to order goods
online e.g. when reduced mobility makes physical shopping more difficult,
- Safety (making sure entrance doors and windows are locked/closed when leaving the house or
sleeping; checking for water or gas leaks; and turning all but one light off when going to bed, etc),
- Reminders (memory problems tend to be associated to ageing and thus support may be needed in
taking medication and fulfilling household tasks),
- User-friendly interfaces (for all sorts of equipment in the home and outside, taking into account
that many elderly people have impairments in vision, hearing, mobility or dexterity),
- Telemedicine opens up new opportunities for providing medical care to the home and there are
many new developments in ICT-based home care, including ways of monitoring wellbeing and
providing a secure home environment,
- Personal health systems include wearable and portable systems for monitoring and diagnosis,
therapy, repairing/substitution of functionality and supporting treatment plans for individuals with a
chronic disease – (e.g. heart disease and diabetes), complemented by telemonitoring and telecare,
thus avoiding hospitalisation,
- Support for people with cognitive problems and their carers to stay at home for longer and
remain active for as long as possible, e.g. through cognitive training, reminders, GPS tracking etc.,
- Support for more efficient workflows in care, by integrating health and social care through
sharing information, monitoring and follow-up to interventions across different organisational and
physical boundaries.
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Future developments in many of these areas are underpinned by some key emerging technologies.
These include robotics, new materials and biosensors. In addition, the emerging concept of Ambient
Intelligence offers great potential, with the possibility for the whole environment (at home, on the
move, in the street, whilst driving or during transportation, in public buildings and so on) to have
embedded intelligence that helps solving everyday life's needs.
ICT-enhanced equipment, processes and delivery mechanisms can help to increase the quantity,
value and quality of services provided to older persons (at equal or lower costs), especially in terms
of short and medium-term health and social care, informal carers and personal assistance services.
3. What are the benefits for the elderly users, the society and industry overall?
Policies and initiatives aimed at promoting the conditions and technologies for ageing well in the
information society, can achieve a threefold objective:
- Facilitating easy use of information society tools and services for the elderly, inter alia, removing
barriers, making ICT tools easier for everyone to use, and encouraging people to make the best of
them to enhance their independence in good health, to participate in work, and to be active in
society;
- ICT can help to increase the efficiency and quality of social and health care delivery to a
growing ageing society, and contribute to the financial sustainability of these services in the future;
- Due to the almost global phenomenon of ageing, innovating ICT products and services in ways
to capture the needs of the ageing society gives the European industry, which is leading in this area,
a substantial export base in global markets.
4. What is the market potential and benefits related to ICT for ageing well?
- It is estimated that Europeans over 65 possess wealth and revenues of over €3000 billion, thus
representing a huge market potential.
- For example, the market for smart homes applications (age-related assistance in shopping,
dressing, moving independently) will triple between 2005 and 2020, from 13 million people up to
37 million. This trend will be reinforced by the fact that incidence of disabilities is higher with age.
It is estimated that 68 million people in 2005 had several forms of age-related impairment. This will
grow to 84 million in 2020.
- Evidence also points out at the fact that ICT can improve the delivery and efficiency of health
and social care systems.
Example: it was calculated that the introduction of mobile health monitoring would translate into
early patient discharge from hospitals, thus saving up to €1.5 billion p.a. in Germany alone. Up to
€1.5 billion/year savings through early patient discharge (Assuming 3 days less hospital stay for
20% of patients, Source: GesundheitScout 24 GmbH & Bayerisches Rotes Kreuz).
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Example: Scotland Telecare Development Programme 2007/8 – 2009/10
Based on actual operational savings analysis, these will over the period 2007-2010 be a minimum
of:
- 46,500 hospital bed days saved by facilitating speedier hospital discharge;
- 225,000 care home bed days saved by delaying the requirement for people to enter care homes;
- 46,000 nights of sleepover care and 905,000 home check visits saved by substitution of remote
monitoring arrangements.
Collectively, these savings are valued at around £43 million - an anticipated benefit to programme
funding cost ratio of 5:1.
Example: UK - Department of Health estimates that ICT enabled self-care could potentially reduce
GP visits by 40%, outpatient visits by 17%, hospital admissions by 50%, length of hospital stay by
50% and number of days off work by 50%.
5. What are the main challenges in deploying these technologies?
The majority of older people do not yet enjoy the benefits of the digital age - low cost
communications and online services that could support some of their real needs - since only 15%
use the internet. Severe vision, hearing or dexterity problems, frustrate many older peoples' efforts
(21% of the over 50s) to engage in the information society.
The market of ICT for ageing well is still in a nascent phase and does not yet fully ensure the
availability and take-up of the necessary ICT-enabled solutions:
- Markets do not sufficiently deliver the necessary ICT-enabled solutions. The reasons include:
o Barriers to innovation such as insufficient awareness of market opportunities and users' needs,
lacking effective public policies to stimulate innovation in the public sector;
o Unclear business models for industry due to fragmented reimbursement schemes related to ICT
and lacking policies for sustained investments, who pays?
o Many legal (e.g. privacy, liability) and technological barriers (e.g. interoperability, complexity,
costs) remain for ICT to deliver its benefits widely;
o Fragmentation of innovation efforts, and high costs of technology development and validation,
insufficient attention is given to the needs of older users when designing new technologies and
services; approaches like inclusive design or design-for-all are not yet widespread.
For example:
- Despite the fact that the ageing population will soon constitute a mainstream market, its specific
needs are not fully taken into account in the design of ICT products and services that still remain
complicated to use and enjoy;
- Even when technology exists and can be effectively used, ICT systems often don't talk to each
other – or are difficult to assemble - due to lack of interoperability and standardisation. Therefore,
services and solutions become abnormally costly and difficult to use for the ageing society and for
people with forms of disabilities;
128
- In many cases the public policies do not provide sufficient incentives for investments in
innovation and efficiency increases, for example by allowing efficiency gains to be reinvested for a
period of time. Furthermore there is often a split between health care and social care funding which
creates both organisational problems and in some cases result in benefits achieved in a different
area, than where the investments takes place.
The EU Action Plan for Ageing Well in the Information Society
In response to these challenges and opportunities, the European Commission has launched an
Action Plan for Ageing Well in the Information Society1 with the following measures:
Raising awareness, and building consensus via stakeholder cooperation and the establishment of
a best practice internet portal and European award scheme for smart homes and independent living
applications;
Status: A best practice portal has been established at http://www.epractice.eu where a number of
ICT & Ageing related cases can already be found. A first set of eInclusion awards have been given
in 2008, see http://www.e-inclusionawards.eu/. In addition a multi-stakeholder innovation platform
has been set up through the AALIANCE project (http://www.alliance.eu) and two ministerial events
were
held
in
Lisbon
in
2007
and
Vienna
in
2008.
see:
http://ec.europa.eu/information_society/activities/einclusion/events/index_en.htm for more details;
Overcoming technical and regulatory barriers to market development, through market
assessments, studies and benchmarking and by facilitating the exchange of best practice between
Member States;
Status: A major study was completed in 2008 to provide an overview of the usage of ICT products
and services by elderly people, see:
http://ec.europa.eu/information_society/activities/einclusion/docs/swa2finalreport.pdf.
Another study analysing the current market conditions and barriers in 10 representative European
countries, the US and Japan is under way, see http://www.ict-ageing.eu/.
Accelerating take-up through, for example, a set of pilot projects under the ICT Policy Support
Programme and use of Structural Funds;
Status: 10 large pilot projects related to ICT & ageing are being launched with involvement of
more than 30 European regions, for further information see:
http://ec.europa.eu/information_society/activities/einclusion/research/projects/index_en.htm#CIP_p
rojects.
Collaboration has been started with DG Regio to disseminate good practice on ICT & Ageing
solutions, e.g. through the annual Regions for Economic Change conferences.
Boosting research and innovation to foster the emergence of innovative, ICT-based products,
services and systems for Europe's ageing population. This includes a dedicated action in the 7th
Framework Programme and EC support to the new Ambient Assisted Living Joint Research and
Innovation programme involving 23 European Countries.
1
http://ec.europa.eu/information_society/activities/einclusion/policy/ageing/action_plan/index_en.htm.
129
Status: More than 30 ageing related R&D projects have been launched under Framework
Programme 6 and 7 until now, for further information see:
http://ec.europa.eu/information_society/activities/einclusion/research/ageing/index_en.htm.
The
Ambient Assisted Living Joint Programme has started operations and a first batch of 21 projects is
under way, see http://www.aal_europe.eu for further information.
Between now and 2013, the EU and Member States, and the private sector will invest more than €1
billion in research and innovation for ageing well: some €600m in the Ambient Assisted Living
Joint Programme, an expected €400m in the EU's latest research framework programme and so far
more than €50m on large scale pilot projects in the EU's ICT Policy Support Programme.
Future policy framework for ICT & Ageing
The ageing of the population will remain a clear societal challenge but will also offer many
opportunities for new ICT products and services. New policies which promote introduction of ICT
and innovation in the care sector are emerging at national level, e.g. in United Kingdom2 and
Denmark3, and also at EU level these policies are now being mainstreamed4.
The EU action plan on Ageing Well in the Information Society launched in 2007 has been
confirmed as highly relevant to support the process but needs to be continued and reinforced.
Following the results of the public consultation5 and consultation6 of the Member States, the
following recommendations for future ICT & Ageing policy directions have emerged:
1. The EU Action Plan on Ageing Well in the Information Society should be continued and
extended as a priority;
2. Further efforts should be launched to systematically introduce Open Method of Coordination in
the field of ICT and Ageing, including development of useful indicators, systematic collection of
statistics, benchmarking and policy learning;
3. Further efforts should be invested in development of socio-economic impact assessment
indicators and methodologies at European level, with involvement of Member States, Regions and
Industry;
4. The current pilot projects under the ICT Policy Support Programme should be extended to allow
for further coverage of regions across Europe and scaling up of pilots towards larger numbers of
users to address scalability issues;
5. Further work should be invested in developing public procurement guidelines and shared precommercial procurement exercises in collaboration between industry and the demand side;
6. Due to the great potential of new ICT to contribute to the field of Ageing, Research,
Development and Innovation efforts should be reinforced. This should build on the successful
efforts in the EU Framework Programmes and on the innovative AAL Joint Programme as a central
element.
2
Large scale system demonstrators (Department of Health/Technology Strategy Board)
http://www.dh.gov.uk/en/Healthcare/Longtermconditions/wholesystemdemonstrators/DH_084255.
3 Danish Initiative on Labour Saving Technologies in the Care Sector,
http://www.abtfonden.dk/Om_Fonden/~/media/abtfonden/Informationsmateriale/ABT_general_presentation.ashx.
4 Commission's 2009 Ageing Communication: "a renewed strategy for tackling Europe's demographic challenge",
http://ec.europa.eu/economy_finance/thematic_articles/article14761_en.htm.
5 See http://ec.europa.eu/information_society/activities/einclusion/survey/index_en.htm.
6 See http://ec.europa.eu/information_society/activities/einclusion/groups/limassol/index_en.htm.
130
Ageing Statistics in Europe (Source Eurostat 2008)
131
TECHNOLOGY ADOPTION BY OLDER ADULTS:
USABILITY PLUS X
Anna Elisabeth Pohlmeyer 1,2 and Lucienne Blessing 2
Despite the prospect that technology can enable prolonged independent living and active aging, this
will only come true if older adults accept the according technology and feel motivated to use it. This
paper highlights the importance of user-centered design in the realm of gerontechnology in order to
ensure technology adoption. It is being argued that simply addressing usability-related issues is not
sufficient to evoke the user’s interest and willingness to adopt a system. Aspects from user
experience research will be introduced and integrated.
1. Two Trends: Converging or Diverging?
1.1. Technology Explosion in an Aging Society
In Europe, we are currently facing two simultaneous trends in society: a demographic shift towards
an aging society and a rapid evolution of technological solutions in everyday surroundings. It is one
of the greatest challenges of our times to ensure that older adults will be able to maintain physical,
cognitive, and social activities. In addition, elderly should be able to prolong an independent living
state (if desired) and should be provided with optimal health care.
At the same time, technology is becoming an integral part of our everyday lives: not only at the
workplace but also smart home environments, online banking and shopping, the popularity of social
media networks and new communication solutions exemplify the variety of applications.
Technological development such as the miniaturization through microprocessors, ubiquitous
computing as disappearing technology and sensor-aware environments illustrates the less apparent
integration of technology in society.
Both trends combined seem like a plausible future scenario: technology assisting older adults in
managing an independent and still active lifestyle.
1
University of Technology Berlin, Center of Human-Machine Systems, Franklinstr. 28/29, FR 2-6, 10587 Berlin,
Germany.
2 University of Luxembourg, Engineering Design and Methodology, Campus Limpertsberg, 162A, avenue de la
Faïencerie, L-1511 Luxembourg.
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1.2. Hopes and Fears
There is great hope that technology has the potential to improve and uphold the quality of life of
older adults. Possible contexts for this target group range from the workplace (e.g. telecommute) to
home environments (e.g. online shopping, information seeking) and the healthcare sector (e.g. telemonitoring). Communication with friends and family who live at distant places can be facilitated,
enrolment in online education facilities becomes an option, access to information, and
compensatory solutions for age-related declines (e.g. reminders) are just some areas where older
adults could benefit from the use of technology [6]. However, it should also be noted, that despite
growing knowledge regarding age-related demands on interactive systems with respect to usability
issues [11] and the existence of general design guidelines [6, 11] this knowledge base is not being
applied on a regular basis. As a result, to date, older adults still face sub-optimally designed
systems. Many elderly underestimate their competence in the use of technology [16] and show low
self-efficacy beliefs and sometimes even computer anxiety [10]. This ultimately leads to a less
pronounced integration of technology in their lives then what would seem appropriate given the
anticipated benefits [5]. Partly, these attitudes are due to a lack of prior experience [14].
Docampo [9] distinguishes two technology generations based on different types of interfaces people
encountered: the electro-mechanical generation (born before 1960) and the software generation
(born in 1960 or later). Today’s seniors belong to the electro-mechanical generation. For that reason
many have different mental models when approaching a digital system. It is less age per se than
prior experience, competence beliefs, cognitive abilities, and education that determine the openness
toward new technologies [5, 10, see also 3].
Taken together, the two trends of an aging society and an increasingly technological environment
have the potential to converge in a way that will enable older adults to uphold a lifestyle of high
quality. Some consequences could be social connectivity and integration (especially crossgenerational), medical support, autonomous living, and access to information and education.
However, if the solutions are ill-designed or ill-introduced they will not be accepted and the two
trends will literally diverge.
2. User-Centred Design for the Elderly
When designing ICT solutions for an aging society, we must bear the big picture in mind as
outlined previously (e.g. demographic change). However, in addition, we must also be aware of the
details on the small scale level. Designing for a society means designing for the individuals who in
the end make the society. Thus, here, details are of interest considering the smallest, but nonetheless
the most crucial entity: the user.
2.1. Impairment-Focused vs. Positive Approach
It is a pity that if designers focus too much on age-related declines they sometimes overlook what
kind of skills are still maintained up to very high age. As we age, we do eventually encounter
cognitive declines [4] and physical impairments [15]. These developments need to be addressed in
system design for older users. However, exclusive problem-oriented approaches will unlikely lead
to acceptance by the user (in those cases where the necessity of usage is not indispensible). Systems
will not be appreciated if they communicate “disability” to others and if they neglect aspects of
product appraisal apart from ergonomics. User-centred design should respect the user with all his or
133
her weaknesses and strengths, needs and desires. Such a holistic mind-set is in this case also the
humanistic mind-set.
2.2. User Experience
In the past decade, the HCI community has increasingly recognized the power of “positive design”
[2, 12]. Human-technology interaction is more than just task-fulfilment within a minimum time
frame. In addition to instrumental, pragmatic qualities of a system (e.g., usefulness, usability), users
also take so-called non-instrumental, hedonic qualities (e.g. aesthetics) into account when
evaluating a system. [13]. The inclusion of both types of product qualities has emerged to the
evolving research field of user experience.
The impression arises that design for the elderly still equates to an attempt of “easy to handle” and
“easy to use” products. Far less attention has been devoted to hedonic attributes. However, these
aspects might play a key role in technology adoption. So far, this emphasis on ergonomics
(cognitive as well as physical) has not been questioned. Indeed, elderly do have a number of
amplified needs due to decreased auditory and visual acuity, for example. Yet, these pragmatic
attributes do not necessarily have to be a trade-off with respect to other design aspects, such as the
visual appeal, the experienced pleasure, or the identification with a product or brand. It is time to
consider all facets of a user experience also when designing for an older target group: physical,
cognitive, and emotional. Again, this calls for a holistic view of the user.
3. Technology Adoption
A prerequisite of successful enhancement and prolongation of active aging through ICT solutions is
the acceptance and adoption of such systems through the user. If this is not given, technological
solutions, regardless of their theoretical benefit, will not have an impact.
3.1. Technology Acceptance Model
The most influential model in this field is the Technology Acceptance Model TAM by Davis [7, 8].
It is a regression model that predicts actual system use mainly through the user’s perceived
usefulness and perceived ease of use of the system. The model has been empirically validated
numerous times [1, 20] and is meanwhile well established in the community. However, one should
bear in mind that the model is based on findings from the work context and not from consumer
electronics and that there have been some substantial technological improvements since 1989.
Nowadays, users are not grateful anymore just because they are able to use a system. They expect
more. We argue that technology acceptance is influenced by pragmatic/ instrumental as well as by
hedonic/ non-instrumental attributes.
3.2. Technology Adoption and Aging: Beyond the Instrumental
Recently, we conducted an ethnographic study [for details see 18, 19]: Younger (20-33 years) and
older (65-80 years) participants were asked to state general motivating and de-motivating reasons,
respectively, regarding the use of technological, interactive products. Results demonstrated a
pronounced diversity of technology acceptance criteria. These surpass mere usability-related
aspects and can be better summarized as dimensions of user experience. Following a systematic,
134
qualitative content analysis as proposed by Mayring [17] 32 different categories of reasons were
identified and subsequently collapsed to the following eight main categories:
- usefulness,
- ease of use,
- ergonomics,
- quality,
- aesthetics,
- match user-product (identification),
- emotion,
- costs.
To conclude, instrumental along the lines of non-instrumental qualities seem to be of relevance with
respect to technology adoption. As TAM [7, 8] tries to anticipate system use through perceived
usefulness and perceived ease of use, the results from the current study demonstrate an extension of
the list of influencing factors. Surprisingly, subsequent frequency analysis did not show any age
differences across the categories. In other words, older and younger adults seem to have the same
criteria upon which they base their decision on, whether or not to engage with an interactive
product. Usefulness and usability (ease of use) are just two of many. The variety of desired qualities
should be taken into account when designing interactive products - for younger and for older adults.
Especially in the realm of Ambient Assisted Living, where privacy issues additionally challenge
technology adoption, acceptance is an inevitable prerequisite. ICT solutions should be carefully
designed for and introduced to older adults.
4. Conclusions
- The user, in particular the older user, should not be reduced to bits and pieces of disabilities.
Instead, a holistic, here it would even be appropriate to call it a humanistic, approach should be
standard.
- People don’t want less as they age. They might want different things, but not less. Just as younger
adults, older adults demanded instrumental as well as non-instrumental qualities of a technological,
interactive system in order to be considered worthwhile adopting.
- Designing for technology adoption includes more than just considering usability-related aspects.
In addition to a variety of needs, there is a substantial variety of wants. Increased attention should
be paid to what makes the x-factor in the equation of technology adoption = usability + x.
5. Acknowledgments
This research was supported by the National Research Fund Luxembourg (AFR) and by the German
Research Foundation DFG (Nr. 1013 ‘Prospective Design of Human-Technology Interaction’).
6. References
[1] ADAMS, D.A., Nelson, R.R., & Todd, P.A., Perceived Usefulness, Ease of Use, and Usage of Information
Technology: A Replication, in: MIS Quarterly, 16 (2), 227–247 (1992).
135
[2] BLYTHE, M.A., Overbeeke, K., Monk, A.F., & Wright, P.C., Funology: From Usability to Enjoyment,
Dordrecht, NL 2004.
[3] CHARNESS, N. & Boot, W.R., Aging and Information Technology Use. Potentials and Barriers, in: Current
Directions in Psychological Science, 18 (5), 253-258 (2009).
[4] CRAIK, F.I.M. & Bialystok, E., Cognition through the lifespan: mechanisms of change, in: TRENDS in Cognitive
Sciences, 10(3), 131-138 (2006).
[5] CZAJA, S.J., Charness, N., Fisk, A.D., Hertzog, C., Nair, S.N., Rogers, W.A., Sharit, J., Factors Predicting the Use
of Technology: Findings From the Center for Research and Education on Aging and Technology Enhancement
(CREATE), in: Psychology and Aging, 21(2), 333–352 (2006).
[6] CZAJA, S.J. & Lee, C.C., Information Technology and Older Adults, in: J.A. Jacko & A. Sears (eds.), The HumanComputer Interaction Handbook (777-792), New York, NY 2007.
[7] DAVIS, F.D., Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology, in:
MIS Quarterly, 319-340 (1989).
[8] DAVIS, F.D., Bagozzi, R.P., Warshaw, P.R., User Acceptance of Computer Technology: A Comparison of Two
Theoretical Models, in: Management Science, 35(8), 982-1003 (1989).
[9] DOCAMPO RAMA, M., Technology Generations handling complex User Interfaces, Eindhoven, NL 2001.
[10] ELLIS, R.D., & Allaire, J., Modeling Computer Interest in Older Adults: The Role of Age, Education, Computer
Knowledge, and Computer Anxiety, in: Human Factors, 41(3), 345–355 (1999).
[11] FISK, A.D., Rogers, W.A., Charness, N., Czaja, S.J., Sharit, J., Designing for Older Adults: Principles and
Creative Human Factors Approaches. CRC Press, Boca Raton, FL 2004.
[12] HANCOCK, P.A., Pepe, A.A., & Murphy, L.L., Hedonomics: The Power of Positive and Pleasurable Ergonomics,
in: Ergonomics in Design, 11(1), 8-14 (2005).
[13] HASSENZAHL, M., The Effect of Perceived Hedonic Quality on Product Appealingness, in: International Journal
of Human-Computer Interaction, 13(4), 481-499 (2001).
[14] JAY, G.M. & Willis, S.L., Influence of Direct Computer Experience on Older Adults Attitude Towards Computer,
in: Journal of Gerontology: Psychological Sciences, 47, 250-257 (1992).
[15] KETCHAM, C.J., Stelmach, G.E., Age-related declines in motor control, in: J.E. Birren & K. W. Schaie (eds.),
Handbook of the psychology of aging, Oxford, UK 2001.
[16] MARQUIÉ, J. C., Jourdan-Boddaert, L., & Huet, N., Do older adults underestimate their actual computer
knowledge? in: Behaviour and Information Technology, 21, 273-280 (2002).
[17] MAYRING, P., Qualitative Inhaltsanalyse. Grundlagen und Techniken, 9th, Beltz Verlag, Weinheim 2007.
[18] POHLMEYER, A.E. & Blessing, L., To Use Or Not To Use. Good Is Not Always the Opposite of Bad, in:
Designing Pleasurable Products and Interfaces DPPI09, 99-103, Compiegne, France 2009.
[19] POHLMEYER, A.E., Blessing, L., Wandke, H., & Maue, J., The Value of Answers Without Question[s]. A
Qualitative Approach to User Experience and Aging, in: M. Kurosu (ed.): Human Centered Design, HCII 2009, LNCS
5619, 894–903 (2009).
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[20] TAYLOR, S. & Todd, P., Assessing IT Usage: The Role of Prior Experience. MIS Quarterly, 19, 561-570 (1995).
137
AMBIENT ASSISTED LIVING:
RESOURCES AND BARRIERS
Claudia Oppenauer1 and Ilse Kryspin-Exner2
1. Introduction
Ageing in situ with the support of technology has become a popular research field and has resulted
in products from various technology disciplines [3] with different technological impacts [16].
Improving the quality of life of old people is one of the aims most referred to - concerning the
implementation of technology in old age. The growing population of older people in industrial
countries and changes of family structures, demand affordable solutions in order to encourage the
social participation of old people and to satisfy their needs of ageing in situ. Technology can be a
significant resource for older people if the users perceive a device or system as being helpful and
not stigmatising or too complex. Technology acceptance not only depends on needs and attitudes of
older people but also on age, gender, level of education and health, and social and cultural
conditions [8]. Contrary to stereotypes, old people are willing to use new technologies but
acceptance and use are only achieved if adequate training is provided and if the end-users
experience subjective benefit from the technology [14].
Recently, motivational factors in particular awoke interest in research studies. Findings suggest that
perceived benefits and costs play a major role and correlate highly with usability [10, 11].
Nevertheless, there is a lack of literature about motivation and needs in old age. Consequently,
fundamental research in these concerns in gerontology is required. Related to old age, loss of social
contacts and loneliness are discussed with regard to modern technology. On the other hand, it is
possible that technology enhances social life and encourages old people in their social participation.
Thus, competence in using technology will become extremely relevant for successful ageing and
well-being [6]. Older people will be confronted with a wide range of new devices, systems and
interfaces in the future. This new complexity demands a high level of cognitive functions,
flexibility and the willingness to learn of the end-users.
Identified resources and possible barriers resulting from homes with complex and smart technology
are discussed from a psychological point of view below. Firstly, cognitive theories and learning
aspects are considered. Furthermore, the importance of social relationships is emphasised by the
approach to successful ageing. Finally, ethical aspects are highlighted with regard to a more
realistic view of older people and by illustrating the importance of needs and attitudes concerning
the use of technology in old age.
1 University Vienna, Faculty of Psychology, Institute for Clinical, Biological and Differential Psychology;
Liebiggasse 5, 1010 Vienna, Austria; [email protected].
2 University Vienna, Faculty of Psychology, Institute for Clinical, Biological and Differential Psychology;
Liebiggasse 5, 1010 Vienna, Austria; [email protected].
138
2. Cognitive functions and the importance of training in old age
Besides multi-morbidity and fundamental health changes in old age, cognitive functions begin to
decrease with age. Yerkes [17] showed that a decline of cognitive functions was already evident by
the age of 30. Although these results have to be interpreted in connection with the selection criteria
used during military recruiting in the 1930s, this idea of ageing going hand-in-hand with deficits
continued. Ageing is still seen as a physical, psychological and cognitive declension. Since a much
more sophisticated view was needed, a different picture of intelligence and cognitive functions was
generated and was able to distinguish between crystallized and fluid intelligence. Whereas the
former refers to the knowledge and life experience of a person and takes them into old age, fluid
intelligence subsumes measureable cognitive functions such as reasoning, concentration or memory
and tends to decline across the lifespan [7]. Nevertheless, cognitive functions such as attention or
memory have a certain amount of plasticity and need daily training to inhibit a decline.
Further, it is well known that actions are unlearned if they are no longer exercised. Concerning the
scenario of smart homes, this approach is also linked with the theory of learned dependence [1].
The phenomenon of learned dependency was observed in health care settings and family systems.
Claims for independency and autonomy as well as resources and competences of older persons are
often ignored by caregivers and family members. If assistance and support is provided in situations
where a person would be able to cope on his/her own, it becomes redundant for that person to carry
out this activity any longer. Due to lack of training, the person will unlearn certain activities in this
situation and will lose more and more independence. .
Since studies going beyond pilot testing are not available, it is an unknown variable as to how users
would decide with regard to the amount of activities they would be willing to do independently or
with technological assistance. For example, some users will experience a robotic vacuum cleaner as
very helpful, whereas others regard this part of housekeeping as relevant for their daily routine and
a symbol of fitness and autonomy. Eventually, the implementation of ambient-assisted living in the
future would possibly influence the discussion of prevention and health promotion strategies since
training of cognitive or physical functions would be less implemented in daily life routine.
3. Successful ageing
One of the most contradictory models of successful ageing is the Activity Theory by Tartler [15] and
the Disengagement Theory by Cumming and Henry [5]. Although both theories are already obsolete
and replaced by more recent ones, they started a discussion about the influence of social contacts
and role functions on well-being in old age. The Theory of Activity proposed that social
relationships and role functions are essential for psychosocial well-being in old age. On the other
hand, Cumming and Henry argued that old people move towards social isolation. Retreat is seen as
a natural process which is necessary in old age. Both the above-mentioned theories have provoked
intensive discussions in gerontology. Apart from the contrary point of view, these two theories dealt
with the aspect of social relationships and networking. Carstensen [4] strengthens this aspect in her
Theory of Socio-emotional Selectivity even more by differentiating two main goals of social
relationships across the life span: whereas information and knowledge seeking are the main goals of
social relationships at a younger age, old people maintain their social relationships for emotional
regulation and consequently have fewer but more intensive social contacts. Intimacy becomes more
important than a high number of different contacts in order to obtain relevant information.
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Not only do theories of ageing deal with social contacts, but also concepts of the quality of life in
old age. A World Health Organisation (WHO) working group developed a quality of life module
for use with older adults [13]. By interviewing focus groups, six aspects in addition to the main
quality of life questionnaire could be found:
1.
changes in sensory abilities,
2.
autonomy,
3.
past, present and future activities,
4.
social participation,
5.
death and dying,
6.
intimacy.
These results emphasise the importance of intensive social contacts and support the theory of
Carstensen. Whether ambient-assisted living including information technologies could assist old
people in maintaining their social contacts remains unclear since most systems are still on a
prototype level and have not been evaluated long-term.
The mostly cited theory of successful ageing is the concept of Baltes and Baltes [2] and their model
of Selective Optimisation and Compensation. Age-releated changes and losses make it necessary to
select certain areas and activities in life in order to make optimisation and compensation possible.
The concept postulates that only high effort allows the continuation of certain activities in old age.
According to this model, technology could play a significant role in compensating restricted
functions and resources. Smart home technology could mainly compensate losses in instrumental
activities of living (IADL) such as reminders to take medicine, managing financial affairs or
organising meals by contacting delivery services. On the other hand, this support would probably
inhibit persons from managing things on their own and eventually from training abilities that are
still functioning properly.
4. Ethical considerations
Ambient-assisted living is mostly linked with monitoring and surveillance systems. A balance
between security management and 24-hour surveillance without privacy is difficult to achieve.
Again, long-term evaluation of such systems is not available to properly discuss user acceptance
and the impact on the daily life of older people. Informed consent, well-prepared information about
the used technology and its consequences are necessary to allow serious decision-making However,
it is not clear which level of monitoring older people are willing to accept if independent living is to
be prolonged by monitoring systems.
Further, especially within the context of monitoring, informed consent is a difficult topic with
regard to patients with dementia. In order to achieve high compliance, it is necessary for users to be
well informed about the technology. Depending on the dementia stage, informed consent cannot be
guaranteed and significant others will take decisions. Another aspect concerns the interdependency
of quality of life: it is well known that patients take decisions in order to unburden their relatives.
For engineers, it is important to integrate ethical aspects in the study design and to be aware of the
relationships and dynamics within the social network of the end-users.
Social participation with the help of technology is definitely a benefit but there is a risk of
neglecting real social contacts, especially if people have restrictions in mobility. The perception of
older people with regard to the quality of virtual communication should be evaluated in order to
develop areas in the system which enhance real face-to-face communication. Finally, the needs of
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old people always have to be taken into consideration as technological assistance and support will
only be accepted and used if old people perceive the technology as being useful. If the use of a
technology provides no benefits or creates new problems, it will be rejected [9].
Above all, the most challenging aspect will be to develop individual technological solutions which
account for the heterogeneity of the older population: different physical and psychological health
status, different needs and interests, different family and social network structures and different
biographies.
5. Outlook
Besides all the discussions about theoretical approaches, it is necessary to investigate the attitudes
of old people to identify their needs concerning ambient-assisted living. Ethical considerations have
to be included in order to guarantee that needs are not only created by engineers and dominated by
financial interests but that technology is developed to support and assist in already known needs and
problem scenarios. This does not conclude that technology just satisfies the need for fun and
entertainment (e.g. games, gadgets) or addresses aesthetical demands.
The above considerations show that an interdisciplinary approach will lead to the most satisfactory
technical solutions for older people. The short overview about psychological theories and models
which could explain or predict acceptance of ambient-assisted living has certain limitations. From
the psychology aspect, simple interventions or guidelines are expected for a better understanding of
the use of technology and its acceptance. Indeed, there is a variety of psychological approaches but
new questions require new research and ongoing controlled testing alongside the evaluation of
existing models, so-called evidence-based research. Although we already know a lot about human
behaviour and experience, this knowledge has to be applied to new hypotheses and scenarios. Thus,
multidisciplinary research is needed in order to study technology acceptance with the help from
different disciplines that can contribute scientific knowledge and methodology [12].
6. References
1. Baltes, M.M. (1995). Verlust der Selbständigkeit im Alter: Theoretische Überlegungen und empirische Befunde.
Psychologische Rundschau, 46, 159-170.
2. Baltes, P. B., & Baltes, M. M. (1990). Successful aging: Perspectives from the behavioral sciences. New York:
Cambridge University Press.
3. Bouma, H., Fozard, J.L., Bouwhuis, D.G., & Taipale, V. (2007). Gerontechnology in perspective. Gerontechnology,
6 (4), 190-216.
4. Carstensen, L.L. (1995). Evidence for a life-span theory of socioemotional selectivity. In L.E. Lewis & M. Haviland
(Eds.), Handbook of Emotions (p. 447-460). New York: Guilford Press.
5. Cumming, E., & Henry, W.E. (1961). Growing old – the process of disengagement. New York: Basic Books Inc.
6. Kaspar, R. (2004). Technology and loneliness in old age. Gerontechnology, 3(1), 42-48.
7. Lehr, U. (2003). Psychologie des Alters. Wiebelsheim: Quelle & Meyer.
8. Marcellini, F., Mollenkopf, H., Spazzafumo, L., & Ruoppila, I. (2000). Acceptance and use of technological
solutions by the elderly in the outdoor environment: findings from a European survey. Z Gerontol Geriatr, 33(3), 169177.
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9. McCreadie, C., & Tinker, A. (2005). The acceptability of assistive technology to older people. Ageing & Society, 25,
91-110.
10. Melenhorst, A.-S., & Bouwhuis, D.-G. (2004). When do older adults consider the internet? An exploratory study of
benefit perception. Gerontechnology, 3(2), 89-101.
11. Melenhorst, A.-S., Rogers, W.-A., & Bouwhuis, D.-G. (2006). Older Adults' Motivated Choice for Technological
Innovation: Evidence for Benefit-Driven Selectivity. Psychology and Aging, 21(1), 190-195.
12. Oppenauer, C., Preschl, B., Kalteis, K. & Kryspin-Exner, I. (2007). Technology in old age from a psychological
point of view. Lecture Notes in Computer Science, 4799, 133-142.
13. Power, M., Quinn, K., Schmidt, S., & the WHOQOL-Old Group. (2005). Development of the WHOQOL-Old
module. Quality of life research, 14, 2197-2214.
14. Rogers, W.A., Mayhorn, C.B. & Fisk, A.D. (2004). Technology in Everyday Life for Older Adults. In D.C. Burdick
& S, Kwon (Eds.), Gerontechnology. Research and Practice in Technology and Aging (pp. 3-18). New York: Springer.
15. Tartler, R. (1961). Das Alter in der modernen Gesellschaft. Stuttgart: Enke.
16. Van Bronswijk, J.E.M.H., Bouma, H., & Fozard, J.L. (2002). Technology for quality of life: an enriched taxonomy.
Gerontechnology, 2(2), 169-172.
17. Yerkes, R.M. (1921). Psychological examining in the United States Army. Washington: National Academy of
Science.
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CompiSternli – KIDS TEACHING ELDERLY PEOPLE
Rahel Tschopp1
CompiSternli are children who offer computer and mobile phone courses to elderly people. One child
introduces the basics to one elderly person. The course speed is determined by the elderly person. The
project has now been running for one year throughout Switzerland.
1. Initial Situation
1.1. Elderly persons
A large number of elderly people have still not yet had the chance to access and use information and
communication technologies (ICT). Very few are willing to take the first step, which is perceived as
being too large or insurmountable. Many are therefore afraid to have a go and think they will embarrass
themselves during the learning process. Many beginner courses require a certain basic level of
knowledge. The methodical and didactical adaptation of courses in line with the abilities of the target
group are often therefore neglected, which is why many courses do not achieve the desired result – or
even exacerbate the defensive attitudes of the participants.
However, children enjoy passing on their knowledge to other people, and elderly people appreciate the
patience displayed by children. They receive personal training. The child holding the course guides the
elderly person through the world of computers or mobile phones, starting with the very basics. The
child knows from its own daily experiences what learning means and what it can effectuate. It displays
a great deal of patience, imagination and humour while conveying the subject matter. For elderly
people, the relationship to the child is often the most important aspect. The result is that they approach
the subject of ICT, which is so foreign to them, in a relaxed and laid-back manner.
Our target audience includes “seniors” as well as persons who wish to catch up and take their first steps
into the world of telecommunications (housewives for example).
1.2. Initial situation of the children
New forms of media need to support a wide range of needs and are often blamed by the press for many
problems in modern society: children and young people grow lonely, are no longer able to deal with
1 Verein CompiSternli; Chegelplatz 3, CH – 7277 Davos Glaris; [email protected]; www.compisternli.ch.
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one another in a respectable manner; they send SMS, surf the web or chat, instead of playing with the
neighbour’s children. The precise effects this has on school life and society are well known: it is
however something that is difficult to deal with. Schools often react with radical measures: mobile
phones are banned. Many parents are unaware of what their children actually get up to on the computer
and generally look the other way. This obvious helplessness of us grown-ups with regard to ICT is also
a contributory factor. Various different kinds of media surround our children and shape their everyday
lives. Children are quick to take up on these, often without a second thought.
Communication between different generations becomes increasingly rare, and mutual understanding
therefore disappears. Grandparents often live in a different location to their grandchildren. Children no
longer write letters of their own accord, and the older generation does not know how to write e-mails or
send SMS. Establishing contact becomes increasingly difficult.
1.3. The basic idea
We think it is important that the participating children take responsibility. They need to learn to stand
up for themselves and take responsibility for their actions. When holding lectures, it is important that
children are allowed to participate and have their say. Young people should have the opportunity to
show what they can do. We want to provide them with the opportunity to increase their self-esteem in a
way that is beneficial to them.
We do not use overhead projectors during lessons, and we rarely use ex-cathedra teaching methods. We
show that computer and mobile phone courses also have to be appealing with regard to how they are
taught and the methods used.
2. Computer Project
2.1. Organisation
The association CompiSternli is looking for people who are willing to expand the project in their own
communities/towns. These persons will be responsible for their local projects, and deal with
coordination, logistics, PR work and some of the fundraising activities. Ideally, they will train the
children themselves. Local schools provide rooms in which to hold the courses.
CompiSternli determines the required standards. Project managers and team leaders are prepared for
their activities during an internal training session, and the training courses for the children are
completed in accordance with a predefined curriculum. The project managers receive a detailed
training plan as well as all the necessary documentation and templates.
2.2. Training courses for the children
The children participate in the project for a whole year, and receive training themselves during the first
six months. This is completed in the form of a weekly one-hour training course, during which they will
get to know how computers work in a fun and exciting way. However, the roles are changed regularly
from the very beginning: the children learn how to pass on the knowledge they have acquired. In doing
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so, they may only use verbal communication, not their hands. They are also often required to work in
small groups or in pairs. This is done in order to counteract the well-known cliché that using the using
the computer is a lonely activity and stunts communication skills.
At the same time, the kids learn the most important rules regarding respectful behaviour and use these
during role-playing. They learn how to speak loudly and clearly; they look at the person when speaking
to them and are polite and courteous. The children also get to know the course schedule, so that they
will be able to work with their “pupils” independently later on.
The courses for the elderly persons always take place in groups. This allows us to maintain
responsibility over the children and offer support whenever necessary, in order to ensure no excessive
demands are placed on the children.
2.3. Training courses for the elderly persons
The courses for the elderly persons are 7 hours long (one hour per week). The objective is to help the
elderly person discover and experience the Internet. The basics are taught first of all: using a mouse and
keyboard as well as basic vocabulary. As soon as they are able to control the computer themselves,
they start to learn how to navigate the Internet. The more proficient “pupils” also learn how to write
and read e-mails. Once they have completed this course, they should feel confident enough to visit a
standard computer course. When beginning the course, 50% of the participants had never owned a
computer. The other half did have one, however, this was usually a really old one passed down from
their daughter or son. It is important for them to own their own computer with all of the usual functions
and programmes.
Training the elderly
Source: Marcel Giger, snow-world
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2.4. Experiences
The courses offered are greatly appreciated by both the children and the elderly persons. Two aspects,
above all, are important for the children: they are allowed to pass on their knowledge and act as a
“teacher”. And: they are allowed to work with the computer and find out how it works.
For the elderly persons, the low initial requirements of the courses and the contact with the children are
important incentives for participation. They appreciate the one-to-one support that is provided by the
children in a relaxed and straightforward manner.
The main difficulty faced by the project is finding suitable participants who are willing to assume
responsibility for the local activities. The combination of ICT expertise and teaching skills is not easy
to find.
It is not always easy to explain something without using your hands
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3. Mobile Phone Project
3.1. Organisation
Groups of young people as well as school classes can register to participate in the “Mobile” project.
Approximately 6 hours are required to train the children (3 x 2 hours). During the training course they
acquire the technical skills and they learn how to deal with elderly persons. Swisscom supports
Compisternli and also provides free mobile phones for use during the training courses. The
participating groups receive the mobiles in advance, so that the children can use them to practise
specific activities. The children are not, however, allowed to use the devices themselves during the
courses to demonstrate anything. They have to give their explanations verbally.
3.2. Training courses for the elderly persons
The courses for the elderly persons last approximately one hour. Making a call, saving and retrieving
numbers, adjusting the volume: these are the topics conveyed by the children. The older pupils often
enjoy using the mobiles a great deal. They ask their young “teachers” to show them how to write “a
little letter” (SMS)…
The kids explain how to save a number.
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3.3. Experiences
“Daniela explained the functions of the mobile phone excellently. She did this so well, that I am now
able to use the different functions of the mobile myself”; the mobile phone training course is greatly
appreciated by the elderly people. The intensive support and comfortable learning atmosphere are very
important to the elderly persons. One of the young “teachers” really enjoyed “showing the older man
how to use the mobile, seeing how much he enjoyed it and the progress he made”.
4. Additional Offers
4.1. Holiday courses
Elderly persons can register for the special holiday weeks in Davos. The children and elderly persons
stay in the same hotel. During the mornings, the children provide one-to-one training to the elderly
persons on the computer. This is followed by a group training programme in the afternoons. The older
pupils therefore have the opportunity to get to grips with the new technologies during the entire week.
4.2. CompiSternli club
CompiSternli kids can become club members. This gives them the opportunity to increase their
technology skills and social competencies. The children have shown that they are capable of assuming
responsibility. The CompiSternli club was founded in cooperation with Microsoft Switzerland.
Microsoft Switzerland will also provide club members with the possibility to participate in regular
events (training courses, tours, etc.) as well as access to Microsoft Switzerland.
4.3. CompiSchule Competence Centre
The CompiSternli Competence Centre, the CompiSchule (CompiSchool), is due to be opened in Davos
in spring 2010. This will allow CompiSternli to expand its range of offers for elderly persons. The
courses are didactically and methodologically geared towards the needs of elderly persons, and
personal support plays an important role. Children and young people are used as co-leaders for courses
that take place outside of normal school hours. The CompiSchule is developing into a place where
children and young people can acquire important competencies, which will be helpful later on during
their working lives. They are allowed to take responsibility. The CompiSchule also provides elderly
persons with access to the world of new technologies. It provides them with an introduction, and this
foundation can then be used to develop and expand their knowledge further.
5. Support
Five foundations [1] have provided financial support in order to ensure the basic range of offers
(computer and mobile phone courses) can be provided for the next three years. Swisscom and
Microsoft Switzerland also support and promote our project. The project will never be able to support
itself financially; we will therefore always be reliant on financial support for the continued existence
and further development of the project.
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6. Summary
The range of offers is very much appreciated, by the participants as well as outsiders. The project
received the “Ritter der Kommunikation” (Knights of Communication) award from the Swiss Federal
Office of Communications in 2007. This prize is awarded to projects that provide an important
contribution towards the development of an information society for all. CompiSternli triggers what we
might call the “Wow” effect. This is extremely helpful, as it can be a real door opener. The system of
conveying knowledge using children works, and it is a win-win situation for all those involved. The
children and the elderly persons benefit, both from the technical aspects and the social ones.
Henry Ford’s (1863-1947) idea guides us through the project: “Anyone who stops learning is old,
whether at twenty or eighty. Anyone who keeps learning stays young. The greatest thing in life is to
keep your mind young”.
[1] Avina-Stiftung, Teamco-Foundation, Ernst-Goehner-Stiftung, Stiftung Mercator Schweiz and MBF foundation
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THE NEED FOR INTEROPERABILITY AND STANDARDS
IN AAL
Ger van den Broek1
1. Introduction
Ambient Assisted Living (AAL) is a very broad application domain with the intention to allow persons
to live longer independently, taking their chronic diseases, impairments and abilities into account, and
give them adequate support while maintaining their privacy and dignity. The AAL domain concentrates
on innovative utilisation of ICT, new ways of user interaction or new types of value chains for
independent living services.
The idea of Ambient Assisted Living also has links to Ambient Intelligence which refers to electronic
environments that are sensitive and responsive to the presence of people. Ambient Intelligence is based
on ubiquitous computing and intelligent social user interfaces. Such an environment would ideally
consist of many invisible, unobtrusive, distributed devices throughout the environment or incorporated
into appliances, furniture or building and that communicate with a variety of services. The environment
would be tailored towards the user’s needs, could recognize the user, would adapt to the user and the
situation and would anticipate the user desires as far as possible without conscious mediation with the
user.
2. Needs
The needs can be divided across two categories of users: the person needed support (elder or disabled
person) and persons delivering care (informal and professional care givers).
Needs from persons needing support will evolve during time (due to specific episodes like
rehabilitation after hospital treatment or degeneration in time) and differ on location (at home, visiting
or on the move), and should be offered in an easy to use way. Some of them are:
• A safe environment to live;
• Provision of food while taking dietary requirements into account;
• Contact to friends and family to maintain a social network;
• Stimulation of physical, social and mental activity to keep physical and cognitive abilities;
1
Philips Research Europe, [email protected], Member of the AALIANCE project (www.aaliance.eu).
150
• Healthcare at home to avoid travelling to the hospital, support in rehabilitation, guidance and
monitoring of medication intake and integrative care for chronic diseases;
• A integrated planning and calendar system to organise the care at home by care givers;
• Planning and organising transport to go shopping, visiting family and friends and other activities
away from home;
• Organising appropriate response when things go wrong.
Some needs from informal care givers like friends and relatives, and professional care givers like home
care nurses are:
• Process events such as warnings related to trends requiring analysis and follow-up or alarms
requiring acute action in efficient way;
• Support communication and data exchange between multiple care givers, integrative care approach;
• Plan care actions at the homes in efficient way, taking travelling into account;
• Automatic data collection to reduce administrative burden.
3. Diversity of products and services
To cope with these needs AAL solutions need components, products, services from different market
segments and offered by a diversity of vendors to work together. Currently those components,
products, and services are stand-alone offerings, in the future they should be able to work together or
have integrated services built on top of them. Market segments that are relevant at this moment are:
• Home automation and control;
• Household appliances;
• Medical devices;
• Consumer electronics;
• Health information technology;
• Telecommunications.
These all have different standards, different terminology, different products, and address very different
markets in terms of price sensitivity, distribution channels, market „players“ etc.
4. The need for collaborative integrated services
An example of a challenge for a future system would be: “Who can design a system that combines fall
detector, vital signs, medication monitor, detects an emergency, establishes contact to a service centre
via a TV set or phone, switches off a cooker, calls for an ambulance, open the door when it arrives and
informs a designated person?”
This example shows the need for collaborative integrated services:
• A fall detection system detects that a person has fallen down;
• Vital signs like blood pressure, heart rate and blood oxygen saturation (SpO2) are measured;
• The medication intakes from the last day are recorded;
• A service centre is contacted and tries to communicate with the person and calls an ambulance;
• Hazardous devices like a cooker are turned off;
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• The door is opened when the ambulance arrives;
• A designated person gets phone call (in case of emergency service) about the event and is informed
about the hospital where the patient will be taken to.
The example above shows the way of thinking and the opportunities, when we are able to develop
collaborative integrated services. However, it will take a lot research and agreements on standards to
achieve this.
Interoperability challenges to cover are:
• The diversity of market segments within AAL;
• A multitude of relevant standards and norms;
• Rivalling standards;
• Integration with healthcare IT;
• Product labelling.
5. Interoperability levels
In this context we consider the following levels of interoperability:
Physical or environmental interoperability to ensure that products to fit together and fit into the
environments and relates to mechanical fit like connectors, EMC regulations, frequencies related to
wireless protocols and the protocols for transmission like IEEE 801.11 and 801.15 families. In this area
CENELEC and TAHI play an important role.
Technical or syntactically interoperability refers to a safe and secure transmission of data. The focus
of technical interoperability is on the conveyance of data, not on its meaning. Technical interoperability
encompasses the transmission and reception of information that can be used by a person but which
cannot be further processed into semantic equivalents by software. Despite this also on this level
certain computational operations can be performed. Examples are the use of a “check digit” to
determine the integrity of a specific unit of transmitted; another example is encryption and decryption
to ensure a secure transmission.
Semantic interoperability allows meaningful exchange of data between systems and service so they
are able to understand each other’s data. To maximize the usefulness of shared information and to
apply applications that reason about the data, a higher level of interoperability is required. This is called
semantic interoperability which has been defined as the ability of information shared by systems to be
understood so that non-numeric data can be processed by the receiving system. Semantic
interoperability is a multi-level concept with the degree of semantic interoperability dependent on the
level of agreement on data content terminology (ontology’s, vocabularies, coding systems) and the
content of archetypes, data models and templates used by the sending and receiving systems.
Process interoperability is a concept that has been identified as a requirement for successful system
implementation into actual work settings. It deals with methods for the optimal integration of computer
systems into actual work settings of humans and includes the following: explicit user role specification,
useful, friendly, and efficient human-machine interface and data presentation/flow supports work
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setting. In the context of aggregated services it deals with service components of different service and
how they complement or depend on each other.
The first two levels are well understood but need agreement on standards and development effort. The
last two levels still need a lot of research.
6. Need for standards related to interoperability levels
Standards are considered here in a general, functional sense as “technical specifications”. From an
institutional perspective one can distinguish four types of standards: official standards which are
mandatory to use, voluntary standards, proprietary standards defined by industry, and open standards.
There are also barriers related to the deployment and adoption of standards, some examples are:
• Focus on internal efficiency: An important barrier seems to be that AAL application, product and
service providers focus on their own needs; they may find their internal process efficiency more
important than commonly used standards to enable an integrated use of their services in a larger
context.
• Standards not designed to user needs: It may be that available standards are not sufficiently designed
to fulfil user needs.
• Ignorance about standards: system and service providers may not be aware of existing standards.
• Implementation/transition costs: Costs of becoming acquainted with the complex specifications and
documentations of standards or the costs of hiring experts may appear to be too high, particularly with
regard to sometimes incompatible updates.
• Migration costs: The costs of migrating from proprietary solutions to other applications that support
fairly common standards may be too high. For example there may be a need to convert massive
amounts of data before new software compliant with standards can be implemented.
• Lack of financial incentive to electronically exchange data with other AAL application and service
providers, which would make the benefits of commonly used standards more obvious.
• Lack of certification: When a certification authority for the relevant standards is lacking, potential
applicants may lack trust that the standards work properly so that benefits of implementing them
outweigh the costs.
The Interoperability working group of the German BMBF/VDE Innovation Partnership on AAL is nonprofit working group addressing issues of Interoperability in AAL2. The group consists of experts from
different domains: Home/building automation, medical IT, household appliances, consumer
electronics, network technology, AAL middleware platforms, sensor networks, robotics, cognitive
systems, standardization and certification. They have conducted a very detailed study covering the very
broad area of AAL in detail. Despite the very large number of standards they have identified they also
detected areas for which no standards exist like: Remote Maintenance of AAL Systems, Connecting to
Medical Sensors, AAL Terminology, vocabularies, ontology’s, AAL Middleware / Service Execution
Environment, Emergency Calls and Connection to Call Centres.
2 The group will publish (in German) their findings in two books on “Interoperability of AAL System Components” Part 1:
State of the Art (Autumn 2009) and Part 2: Roadmap (Spring 2010). It would be a great benefit if something similar would
be available in English.
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7. Beyond standards
Except the development and agreement upon standards there is more to do. The Continua Health
Alliance has selected three domains (aging independently, chronic disease management and health &
wellness) where they want to establish an eco-system of interoperable personal health systems that
empower people and organisations to better manage their health and wellness. To achieve this they
want to:
• Empower individuals and patients to better manage their health by providing them with information
regarding their fitness and health through personal medical devices and services.
• Allow relatives and professional care givers to more accurately monitor and coach chronic disease
patients and elderly individuals living independently.
• Enable medical and fitness device manufacturers to rapidly develop interoperable devices and
services using industry developed connectivity standards.
• Enable health care providers to offer better quality care through personalized health solutions
assembled from a rich marketplace of interoperable health care devices and services.
Considering the CONTINUA association’s scope this can be considered as a subset of the scope for
AAL and they want to tackle the problem by:
• Developing design guidelines (based on existing standards) that will enable vendors to build
interoperable sensors, home networks, tele-health platforms, and health and wellness services.
• Establishing a product certification program with a consumer-recognizable logo signifying the
promise of interoperability across certified products.
• Collaborating with government regulatory agencies to provide methods for safe and effective
management of diverse vendor solutions.
• Working with leaders in the health care industries to develop new ways to address the costs of
providing personal tele-health systems.
It should be noted however that the area on independent living is still much oriented to health related
topics (safety and assistive related topics are still lacking) like: Assistance with daily health and
monitoring tasks, Medical reminders, Activity prompts, Monitoring and early warning using bio-sensor
data collection, Automated dietician, Emergency response, Real-time alerts and communication.
8. Next steps
To improve interoperability of AAL components, products and services a number of steps should be
taken:
• Increase the knowledge about existing standards, translating the book from BMBF/VDE Innovation
Partnership on AAL in to English or even better make it available as a searchable database which is
also maintained.
• It might be a challenge to have a comparable approach to CONTINUA for other segments within the
AAL scope. The development guidelines and the testing and certification activity would be of great
value.
• At the moment CONTINUA concentrates mainly on the syntactical interoperability, except for using
some standards for the exchange of health data. To achieve our goals we have to proceed to the
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semantic and process levels as well and extend beyond the health domain to include the other market
segments involved in AAL.
• Stimulate research to develop standards for the AAL context in the semantic and process
interoperability levels.
Taking these steps will allow device suppliers and service providers to implement collaborative
interoperable systems, comparable to the example above, offering large added value to the users of
AAL systems. The increased efficiency will help to manage the issues of cost control and shortage of
staff in an aging society as well to improve quality of live for the people needing support and care.
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PROJECTIONS OF FUTURE LONG-TERM CARE
EXPENDITURE IN AUSTRIA (2008-2030) WITH SPECIAL
CONSIDERATION OF ASSISTIVE TECHNOLOGIES
Clemens Buchinger and Ulrike Schneider
This article presents findings from cost projections for long-term care (LTC) in Austria based on a
macrosimulation model, spanning the years 2008 to 2030. Most importantly, we deliver first-time
estimates for the cost-saving potential of assistive technologies (AT) in home care. Previous
international studies reveal that AT’s potential to substitute or supplement personal care is highly taskspecific and also depends on the characteristics of the specific devices. Accordingly, findings on the
economic benefit of AT are mixed. There is some promise but no clear evidence that AT will be both
efficient and cost-effective.
The macrosimulation model developed to project future long-term care expenditure in Austria is based
on a number of assumptions and delivers cost estimates for differing scenarios. Depending on our
assumptions regarding the health status of future generations of older people, the supply of informal
care and the unit costs of care, we project LTC costs in Austria will increase by 70% between 2008 and
2030 in the lower bound scenario and by 240% in the upper bound scenario. In order to explore the
cost-saving potential of AAL technologies we assume that one in three older beneficiaries of the public
long-term care allowance – who live in private households and need between 30 to 40 hours of care
per week – will be equipped with a telemonitoring system. We also assume that this system reduces the
individual demand for outpatient care by two hours per week. This would moderate the increase in
costs of LTC services until 2030 by 6.1 percentage points to the effect of a € 231 million in total
savings over the period 2008 to 2030. On average, the product would pay off after 3.8 years on
average.
1. Challenges of Population Ageing
The marked and continuous increase in life expectancy is a major driving force of population aging in
all industrialized countries. At the same time, recent evidence for Europe from the Lancet study (see
Jagger/Gillies et al. [7]) shows that a significant part of the remaining years from the age of 50 onwards
are likely to be troubled by health problems and functional limitations. These developments raise
questions about the sustainability of pension, health and long-term care (LTC) systems in the EU and
other OECD countries. Projections of costs and revenues related to population aging are an important
prerequisite for answering such questions.
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In addition to other variables that influence the aggregated costs of LTC services – such as
demographic changes, the prevalence of being dependent or the regional availability of these services –
technological progress seems to be an important issue concerning the development of LTC costs.
Following the arguments of Pickard [12] and Mühlberger [11], a shortage of formal and informal care
providers will occur in future decades. Thus an evaluation of the economic effects gained through the
implementation of AAL products, especially regarding their capability to substitute or complement
personal care, appears essential.
Against this backdrop, the aim of this article is to estimate the present and future costs of LTC in
Austria until 2030, based on a disaggregated macrosimulation model using different scenarios.
Furthermore, this investigation evaluates the monetary effects of implementing AAL technologies into
care settings. The discussion is structured as follows: Section two describes the Austrian context of
long-term care and summarizes previous studies of AT and their usage in LTC settings. Section three
describes the projection model, the methods employed and outlines the assumptions and differing
scenarios. The last section presents the results of the projections, including the key finding on the cost
saving potential of AT in long-term care.
2. Long-term Care and AAL-Technologies in Austria
2.1 Long-term Care in Austria
In Austria, long-term care is still considered a primary responsibility of families. About 80% of older
dependent persons receive help from family members or their extended social network (see
Klimont/Kytir et al. [8]). In the majority of cases, the care arrangements do not even involve any care
professional or support service. However, the country has taken major steps in offering public support
to persons in need of long-term care and their families (Federal Ministry of Social Affairs and
Consumer Protection [5]):
In 1993 a law was passed which introduced a universal tax-funded care allowance system. This system
grants universal (non-means tested) benefits to persons who need at least 50 hours of care per month.
Benefits are scale-graded, starting with a monthly allowance of € 154 for the lowest level of care need
and reaching about € 1.655 for those in the highest (seventh) category of need. Those in need of roundthe-clock care and living in private households are eligible for a further benefit, which was introduced
in 2008 in order deal with the growing number of illegal care workers in the country. This benefit
amounts to € 550 to € 1.100 per month. In addition to care allowances, long-term care policies also
concern access to professional long-term care services, quality-of-care regulation and information and
referral services.
Responsibilities of public authorities for long-term care have been established on the federal and
provincial level. Most importantly, the nine provinces are in charge of securing access to long-term
care services, which is achieved in a variety of ways, including government aids to nursing homes or
contracts with providers of home care services (see Trukeschitz/Buchinger [13]). The cost projection
for long-term care in Austria presented in section five accounts for this political context. A major part
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of the data for the projection has been collected on the provincial level. Also, we conducted separate
projections for each Austrian province, and finally collated these to obtain results for the entire country.
2.2 National and international evidence from the implementation of AT into LTC
Regarding the implementation and usage of new technologies in long-term care settings, a number of
interesting aspects can be identified in the relevant literature. One of these is the analysis of the
effectiveness of AT and their capability to substitute personal care. Mann et al. [10] separated 104
home-based frail elderly persons from New York into a treatment group which had access to AT, and a
control group which received only usual care services. Based on bivariate analysis he finds no
significant differences in the overall total costs, while the decline in the functional status was greater
for control group participants.
Agree/Freedman [1] used data from 10,028 disabled persons aged 65 and over to study the use of
personal care in conjunction with technical equipment. They show that the capacity of equipment to
substitute or supplement personal care is highly task-specific and depends on the characteristics of the
devices. Furthermore their results suggest that simple technologies substitute personal care, whilst
complex technologies supplement it. Based on the information of a literature survey, Blaschke et al. [3]
divided the new technologies of care into Assistive Technologies (AT) and Information and
Communication Technologies (ICT). Summarizing findings from empirical studies they conclude that
there is some potential, but no clear evidence that AT will be both efficient and cost-effective.
The costs of implementing different forms of AT into varying types of properties and their ability to
amortize was analyzed by Lansley et al. [9]. To this end 8 disability profiles and 3 care settings
(including the necessary adaptations) were defined, combined and observed over a period of ten years.
This study finds that adaptations and AT can be cost efficient for many older disabled people and that
the pay-back periods vary around 2.5 years from the date of investment. Based on the data of 2,638
frail elderly people, Hoenig et al. [6] examined whether the use of AT is associated with fewer hours of
help from caregivers. According to the results of bivariate analyses and multivariate regressions,
dependent people without this equipment reported about 4 more hours of help per week than people
using AT.
Using qualitative analysis, additional quantitative data and secondary research, Waibel [14] analyzed
the Austrian socio-economic framework for AAL technologies for elderly people. He shows that while
a variety of AAL technology-based products are available, their diffusion remains limited. Legal and
bureaucratic complexities of R&D funding, expectations that health and care services have to be free of
charge and other factors obstruct the successful implementation of these technologies. Bechtold et al.
[2] studied requirements for successful R&D of ATs in Austria. They identify the lack of coordination
between many involved agencies and an overly theory-driven R&D as the primary challenges and
propose to agree on common key terms and concepts, and to rely on problem-oriented approaches in
order to overcome these problems.
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3. Model, Methods, Data and Scenarios
In order to project the full costs of long-term care to elderly dependent persons for Austria up to the
year 2030, we developed a dynamic macrosimulation model, which follows the UK Personal Social
Services Research Unit’s LTC projection model (see Comas-Herrera/Costa-Font et al. [4]). Following
the Austrian legal framework, our model is disaggregated to the level of the nine provinces.
The projection required three steps: Firstly, the number of elderly people over 65 years in need of longterm care had to be projected, accounting for demographic trends, the household context of older
people and the age-specific prevalence of long-term care dependency. Secondly, we explored regional
differences and future trends in the provision and unit costs of long term care services. Finally, supply
and demand had to be combined and the full costs of long-term care had to be calculated and projected
as the sum of nine individual evaluations.
As a data basis in the quantitative analyses we use various statistics from the National Statistic Agency
(e.g. population forecast, micro census) and recipient statistics for the care allowance
(Bundespflegegeld) provided by the Association of Austrian Social Insurance Providers (Hauptverband
der österreichischen Sozialversicherungsträger). In order to identify and forecast trends in data we
primarily employed time series methods, such as Double Exponential Smoothing. Qualitative data has
been collected via 13 expert interviews, which focused on the regional provision of LTC services as
well as on the development and implementation of AAL products in Austria. Supplementary
information relating to new technologies was gathered at the 1st AAL Forum in Vienna in October
2009. This information underlies our assumptions regarding the future supply of LTC services on the
provincial level and the implementation of new technologies.
For the purpose of analyzing the variation and sensitivity of projected LTC expenses vis-à-vis key
underlying assumptions we constructed three scenarios (summarized in table 1), which combine
different assumptions concerning morbidity, the rise in unit cost and the development of informal care1.
Table 1: Scenarios and assumptions
worst case
scenario
2 years : 1 year
Morbidity
(gains in life expectancy: Expansion
of
delay
in
onset
of morbidity
dependency)
2.5 % p. a.
unit cost rise
+20%
in residential
informal care
care
baseline
scenario
1 year : 1 year
best case
scenario
0.75 years : 1 year
Compression
of
morbidity
2% p. a.
no change
1.5% p. a.
-20% in residential
care
Source: own illustration
The aim of the baseline scenario was to project the monetary dimension of LTC assuming that past
trends would continue in the future and no exogenous shocks would occur. Thus we fixed the increase
in unit costs at 2% p.a., assured that gains in life expectancy and the delay in the onset of disability
1 Care provided by non-professionals, such as the children or spouse of the frail elderly person
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developed in step with each other and excluded changes in the provision of informal care. The worst
case scenario assumes a 2.5% increase in unit costs, an expansion of morbidity and a rise in the number
of persons in residential care by 20%. The increase in morbidity is expressed by delays in the onset of
dependency by just one year after a two-year increase in life expectancy. Contrarily, the best-case
scenario assumes a compression of morbidity, a lower growth in unit costs and a decrease in residential
care of 20%.
An additional AAL scenario serves to explore the monetary effects of AAL technologies in LTC. This
scenario starts from the assumptions of the baseline scenario and focuses on older persons with
dependency level three (equivalent to 30 to 40 hours of care needed per week), living in private
households and receiving outpatient care as AAL potential users. Although it would also be possible to
take residential care into account, our interviews with experts revealed that these institutions are
already well equipped and technological progress takes place continuously through the replacement of
older devices. Since the costs of this process are covered by higher daily rates or building subsidies,
and as there appears to be no significant gap in the implementation of new technologies, we did not
consider residential care in our AAL scenario.
Among the different possibilities to implement new technologies, an age-based adaption of private
homes, including a telemonitoring video system that allows the supervision of vital or household
parameters and supporting older people performing certain daily activities such as shopping has been
chosen. Against the background of low acceptance of AAL-based products among potential users we
assume that only a third of households sheltering a dependent older person with dependency level three
adopt (new) AAL products. In the year 2008 this would mean that 13,727 persons would receive such a
system. The costs of this type of AAL adaption were quantified with
€ 10.000 and running costs of € 40 per month, the expected time span for the use of the device was
taken to be 8 years. In the absence of empirical data it is assumed that this adaption reduces the need
for professional mobile care services by two hours per week. Compared to the results of Hoenig et al.
[6] which imply a reduction of 4 hours care per week following the use of AAL based products this
seems to be a conservative assumption.
4. Results and Conclusions
The projection of elderly dependent persons in Austria, which built the first step of our cost projections,
yields an increase between 21.2% (best case), 43.3% in the baseline scenario and 53.9% (worst case)
up to the year 2030. In absolute values the macrosimulation suggests that the number of elderly
dependent persons in Austria will rise from 297.330 in the year 2008 to 377.196 (best case), 426.053
(baseline) and 457,567 (worst case) in 2030. Considerable variations can be observed on the regional
level. In the baseline scenario the model estimates the highest growth rates in Vorarlberg (99.7%),
Salzburg (91.8%) and Upper Austria (63.1%), while the increase in the number of older persons in
need of care is lowest in Carinthia (15.6%), Vienna (38%) and Burgenland (44.5%).
The second step of our LTC cost projection comprised the analysis of present and future provision of
LTC services on the provincial level. In the base year 2008, service use was highest in Vorarlberg
where 88.5% of the dependent older people were supported, followed by Upper Austria (64.87%) and
Vienna (62.19%). Burgenland (28.2%), Lower Austria (35.45%) and Styria (36.21%) display the
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smallest shares of LTC service users among their older dependent populations. The projection for the
year 2030 is based on development plans and appraisements from local authorities as expressed in 10
expert interviews. The highest increase of supply and use of LTC services between 2008 and 2030 is
projected for Carinthia (+39.1%), Styria (+20.1%) and Vienna (+17.9%), whereas the share of service
users will decrease slightly in Salzburg (-0.8%). In 2030 supply and use of LTC services will again be
highest in Vorarlberg, followed by Upper Austria (74.11%) and Vienna (73.29%), while the lowest
proportions can be observed in Burgenland (31.95%), Lower Austria (37.30%) and Styria (43.80%).
Finally our model yields an increase in the Austrian full costs of LTC services (see diagram 1) of
122.9% from 2008 to 2030 in the baseline scenario. The increase will be 69.53% in the best case
scenario and 240.8% in the worst case scenario. In absolute values, the costs will increase from
approximately € 2,100 million in the year 2008 to € 3,643 million under best case scenario, € 4,876
million under the baseline scenario and € 7,881 million under the worst case scenario.
Diagram 1: The Costs2 of Austrian LTC Services on the basis of three scenarios in 2008, 2020 and 2030
Source: own illustration and calculation
Diagram 1 also shows that the largest part of the full costs can be attributed to residential care, which
varies between 70.7% (best case) and 81.6% (worst case) in the year 2030. The share of outpatient care
comprises between 15.9% (worst case) and 25.1% (best case), while semi-residential care accounts for
the remaining approximate 2.5% (worst case) and 4.2% (best case). Furthermore the model suggests
average annual building costs of € 10 million (best case), € 108 million (base case) and € 324 million
(worst case) in residential care and € 6.9 million (best case), € 2.5 million (baseline) and € 3.1 (worst
case) million in semi-residential care.
Our AAL scenario results in an increase of long-term care costs by 116.8%, which implies that the
implementation of AAL technologies into households of elderly dependent persons would moderate the
cost increase by 6.1 percentage points. Diagram 2 displays the difference between the costs of
2 Costs are defined as full costs comprising running and building costs.
161
outpatient care according to the AAL and the baseline scenarios over the projection period. In the base
year the implementation costs lead to an increase of 8.8% higher costs for outpatient care in the AAL
scenario compared to the baseline scenario. By reason of a lower demand for outpatient care of AAL
equipped households this costs decrease slightly over time in the AAL scenario. Comparing the results
from the baseline scenario with the cost projection resulting from our AAL scenario, the
implementation of such products would thus reduce the total costs over the years 2008 to 2030 by at
least € 231 million. On average, the required investment would amortize itself after 3.8 years.
Diagram 2: The cost of outpatient care based on AAL and baseline scenario in 2008, 2020 and 2030
Source: own illustration and calculation
In conclusion we can say that an implementation of AAL technologies into the households of frail
elderly people might be one opportunity to limit the increase of future LTC costs. At the same time, we
consider it important to stress that our assumptions are rather conservative and that a reduction in the
demand of formal care services is only one possible economic effect of AAL technologies in long-term
care. Larger effects might result if other positive effects of AAL technologies – such as the prevention
of accidents or a delay in the use of residential care – would be taken into account. Unfortunately,
empirical evidence in this field of research is still in short supply and most studies are partly
representative at best.
References
[1]Agree, E. M.; Freedman, V. A. (2000): "Incorporating Assistive Devices Into Community-Based Long-Term Care: An
Analysis of Potential Substitution and Supplemention", in: Journal of Aging and Health, 12 (3). 426-450.
[2]Bechtold, U.; Sotoudeh, M (2008): Participatory Approaches for Technology and Autonomous Living. Wien. FFG.
[3]Blaschke, Ch. M.; Freddolino, P. P.; Mullen, E. E. (2009): "Ageing and Technology: A Review of the Research
Literature", in: British Journal of Social Work, 39. 641-656.
[4]Comas-Herrera, Adelina; Costa-Font, Joan; Gori, Christiano; di Maio, Alessandra; Patxot, Concepció; Pickard, Linda;
Pozzi, Alessandro; Rothgang, Heinz; Wittenberg, Raphael (2003): European Study of Long-Term Care
Expenditure: Investigating the sensitivity of projections of future long-term care expenditure in Germany, Spain,
162
Italy and the United Kingdom to changes in assumptions about demography, dependency, informal care, formal
care and unit costs. London. PSSRU, LSE Heath and Social Care, London School of Economics.
[5]Federal Ministry of Social Affairs and Consumer Protection (2007): Social protection in Austria. Vienna. Ministry of
Social Affairs and Consumer Protection.
[6]Hoenig, H.; Donald, H.; Taylor, Jr.; Sloan, F. (2003): "Does Assistive Technology Substitute for Personal Assistance
Among the Disabled Elderly?", in: American Journal of Public Health, 93 (2). 330-337.
[7]Jagger, C; Gillies, C; Moscone, F; Cambois, E; Van Oyen, H; Nusselder, W; Robine, J (2008): "Inequalities in healthy
life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis", in: The
Lancet.
[8]Klimont, Jeannette; Kytir, Josef; Leitner, Barbara (2007): Österreichische Gesundheitsbefragung 2006/2007.
Hauptergebnisse und methodische Dokumentation. Wien.
[9]Lansley, P.; McCreadie, C.; Tinker, A (2004): "Can adapting the homes of older people and providing assistive
technology pay its way?", in: Age and Ageing, 33. 571-576.
[10]Mann, W. C.; Ottenbacher, K. J.; Fraas, L.; Tomita, M.; Cranger, C. V. (1999): "Effectiveness of Assistive Technology
and Environmental Interventions in Maintaining Independence and Reducing Home Care Costs for the Frail
Elderly", in: ARCH FAM MED, 8 (May/June 1999). 210-217
[11]Mühlberger, Ulrike; Knittler, Käthe; Guger, Alois (2008): Mittel- und langfristige Finanzierung der Pflegevorsorge.
Wien. Österreichisches Institut für Wirtschaftsforschung.
[12]Pickard, Linda (2008): Informal Care for Older People by Their Adult Children: Projections of Supply and Demand to
2041 in England. London. PSSRU.
[13]Trukeschitz, Birgit; Buchinger, Clemens (2007): Öffentliche Förderung am Beispiel von Dienstleistungen der
Altenpflege und -betreuung - Eine Bestandsaufnahme für Österreich, in: Schneider, Ulrike; Trukeschitz, Birgit
(Hrsg.): Quasi-Märkte und Qualität. Baden-Baden: Nomos.
[14]Waibel, Ulrich (2007): SOPAAL "Feasibility Study sozioökonomischer Parameter für die nationale Implementierung
von AAL". Wien. BMVIT.
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ACTIVE AGEING IN THE COMMUNITY
– AAL AND MOBILITY1
AALIANCE Project
Social participation decreases with age, fundamentally because of three factors: intrapersonal,
interpersonal and structural factors.
The first category includes all personal factors, attitudes and other variables that are inherent to the
individual person and make the participation in, and enjoyment of, leisure activities more difficult.
Such factors include health, financial circumstances, individual aspirations or disillusionment for
life.
The second group includes all circumstances derived from contact with family, friends,
neighbourhoods that frame the practice of leisure activities. Examples of such circumstances are
the loss of loved ones, distance from children or the fact that an elderly person often cannot find
someone to share an activity with.
The third group represents external or environmental factors that influence leisure activities.
Any activities aimed at minimizing any of these factors will promote the social interaction of
elderly within their community.
Despite all these factors, participation levels can be significantly increased with adequate
motivation and support. Thus, elderly people can be supported in finding and carrying out work,
establishing and maintaining contacts with other people, and, in general, can be helped to spend
time participating in different leisure activities.
Promotion of social participation of elderly people can be undertaken in many ways. First of all,
communication services should provide new and easy-to-use facilities so as to help seniors enhance
their social relationships. This is a way of raising self-esteem and increasing the sense of control
and autonomy. A second way is that the elderly should be provided with necessary information
about leisure activities that are adapted to the needs of the person and able to attract his or her
attention and create interest. This can include outdoor activities and volunteering activities. Finally,
mobility is essential for general independence and to ensure good health and quality of life.
1. Going outdoors with AAL
Mobility is essential for general independence and ensuring good health and quality of life. For
1
Excerpt from the AALIANCE Ambient Assisted Living Roadmap (2009). Available on www.aaliance.eu.
164
older people, mobility represents more than having a means of transport, but it is also a symbol of
freedom, independence, self-reliance and having some control of their lives.
Mobility is more than merely moving from one place to another; it can benefit elderly people in
several ways. It provides the elderly with the possibility of travelling to achieve access to desired
people or places. Psychologically, movement in itself or “getting out” induces feelings of
independence and increased self-esteem. Finally, it can help elderly people become involved in
more local community activities.
Although there is a tendency for seniors to move around in their own car, there are numerous
reasons to maintain and improve public-transport systems and raise the awareness of alternative
transport options among older people. However, using public transport can be stressful for older
people: ticket machines are often complicated to use and there is a vast amount of customer
information to take in.
Activities aimed at improving the mobility of the elderly can make public transport more accessible:
physically, by making it easier for elderly people to actually get on a bus;
practically, by providing the right information for moving around a city by public transport and
by providing the means of finding the way through a city using for example a GPS-based system.
2. Supporting individual physical mobility
Walking is sometimes overlooked as a means of transport, despite the fact that it is fundamental to
any journey. Everyone has to walk, even if it is just from the front door to the car or bus stop,
around the house, or around a museum. As people become older, or if they develop impairments,
they become at greater risk in pedestrian environments, finding them increasingly difficult to
negotiate. There are often design conflicts involving street furniture, signage, lighting, rest areas,
amenities, vehicles and road-crossing to consider, but also information about location (positioning),
finding the right way and accessible routes. Geo-referencing and route guidance using satellite,
wireless or mobile-phone technology can help pedestrians, not only by providing relevant and
useful information, but also by giving reassurance in complex, busy or unfamiliar surroundings.
Technologies for older pedestrians
Localization/positioning (i.e. Where am I? What is near me?) and navigation support (Where can I
go? How do I get where I want to go?) requires:
Satellite-technology (GPS/Galileo) combined with a suitable receiving device for outdoor
mobility;
Wireless technologies (e.g. WLAN, Bluetooth, RFID, Near-field communications NFC) for
indoor navigation;
Mobile communcations (4G);
Digital mapping for pedestrians and other information delivered in a variety of formats to suit the
individual;
Web-services providing personalised services from differerent service providers;
Sensor Networks (including wearable sensors, accelerometers or pedometers).
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Roadmap of technologies for pedestrian support
3. Ambient Assisted Driving
In rural areas where public transport is not available or is not provided in an acceptable quality,
driving with a private (or rented) car is essential for independent living. Driving a private car is
often considered as more comfortable and safer and faster than public transport.
Systems for younger or older drivers are not distinguished here because both groups will benefit
from them. Older drivers often show decreasing motoric, sensorial and mental capabilities, as
shown in the figure below, but they use specific strategies to reduce the load caused by the driving
process such as avoiding unknown areas or driving at night or in bad weather conditions. On the
other hand, it is also well known that older drivers have an increased rate of fatal accidents
compared with middle-aged drivers.
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Figure: Problems of older drivers in perception, cognition and action2
For many years, European governments, private organizations and motor industries have been
working hard to make driving more comfortable and, especially, safer - for all road users independent
of age. This includes measures concerning infrastructure, legislation and education and in particular
technical improvements to vehicles. Many other active safety systems are now under development,
mainly concerning the longitudinal and lateral control of the vehicle. Communication between one car
and another car and from car to infrastructure to exchange information which might not be available
in a single car will play a prominent role. These systems will be introduced step by step and in the
future they will grow together to form an Integrated Safety System. As a private car is only one
participant in traffic, many developments aim at reducing the risk to so-called “vulnerable road users”
like cyclists and pedestrians.
The following applications were rated by experts on behalf of the EU regarding their potential
impact on traffic safety:
Priority of vehicle-based autonomous systems:
ESP (Electronic Stability Programme);
blind-spot monitoring;
adaptive head lights;
obstacle & collision warning;
lane-departure warning.
Priority of infrastructure-related systems:
eCall (emergency calls including precise coordinates of the location);
extended environmental information;
2
Schlag, B. & Schade, J. (2008): Traffic and Transportation Psychology. In: K. Button & P. Nijkamp: Transportation
Dictionary
167
RTTI (Real-time Travel and Traffic Information for drivers);
dynamic traffic management;
local danger warning;
speed alert.
3.1. Enabling technologies
The following sensors or systems are crucial for many of the assistance systems referred to in the
previous section. Some of them like wheel-speed sensors or steering sensor are available in nearly
every car and some of them are available in high-priced cars or will be available also in low-cost
cars as soon as an interface between OEM and aftersales systems is established (GPS, Digital Map,
GSM):
Long Range Radar/LIDAR;
camera with object detection, classification and recognition;
short-range radar with narrow/wide angle;
vehicle-to-vehicle communication;
wheel speed sensors;
steering sensor;
GPS;
GSM;
digital map;
traffic detection;
road weather detection;
incident detection.
3.2. Systems with special benefits for older drivers
Older drivers will have the same benefit from these passive and active safety systems as other drivers
or other road users. There are also several products or systems which are especially useful for them as
they are aimed directly at the deficiencies of this older user group.
Such systems are improving safety, vision and driver-system-interaction:
tyres with flat running capability (available);
night-vision systems. Available systems extend the range of vision at night. Advanced versions
provide object classification and can therefore warn of relevant objects like pedestrians and cyclists;
advanced front light (available; systems with extended functionality under development);
blind-spot detection (available; performance will be improved);
head-up displays show driving relevant information as a virtual image several metres in front of
the car, making it easier for the driver to keep his or her eyes on the road and to see the information
that is displayed faster (available; systems with extended field of view and luminance range under
development);
speech input for operation of suitable functions (available; natural dialogue under development);
improved navigation (matching of navigation hints and external world).
Systems improving driving activities:
cruise control with extended range (urban area, stop & go, traffic jams);
detection of driver impairment due to health or drug problems;
detection of driver inattention (gaze direction) and potentially mental distraction;
obstacle & collision warning;
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crash mitigation/avoidance systems;
lane-detection/lane-departure warning/lane-keeping support (available for standard situations;
extended functionality under development);
parking assistance which support or even perform the parking process (informing systems on the
market in large quantities; systems with lateral control available by leading OEMs; with lateral and
longitudinal control in research vehicles available but still problems with detection of all kinds of
obstacles and with legislation/responsibility).
Systems improving comfort and wellbeing:
identification of driver and passenger for adaptive functions;
improvement of thermal comfort (individual, faster reaction);
improvement of acoustic comfort (active noise reduction, intercom between front/back seats);
physical-training devices;
in-car illumination adaptable or adaptive to driver/passenger mood.
4. Public transport
Transport - the ability to get from A to B - is fundamental to independent living. Public transport
must be accessible and easy to use, especially for older people, many of whom do not have access to
- or do not want to drive - a car. This refers not only to the vehicles, but also to the transport
infrastructure such as stations, airports and ticket machines and on-street approaches. Pre-trip
planning should be quick and simple, and on-trip planning should be available so that people can
make adjustments to their journey for whatever reason (social, emergency or change of plan).
There are many different modes of public transport (bus, train, metro/subway, air, taxi, ferry), and it
is vital that integration of the services (usually a political issue) and integration of information
(usually a business issue) takes place where possible. Such measures enhance the convenience and
simplicity of using public transport, which in turn (and in combination with measures such as travel
training) increases user confidence.
The aim is to provide a seamless journey, with full information about facilities, travel times, and
any potential barriers to accessibility. Provision of a comprehensive multi-modal public-transport
system that is easy and reliable to use is a great aid to social cohesion as it provides better access to
services and better support for local communities.
Travel information technologies
Travel information (e.g. timetables, amenity information and physical access information):
use of web-based technologies to supply on-trip information to mobile devices;
improved information in vehicles, at stations, etc.;
information delivered in a variety of formats to suit the individual;
information delivered at home;
real-time information with a short response time.
Many of the same technologies that are beneficial to pedestrians are also beneficial to publictransport users, although they might use different functionality and perform different tasks. Apart
from mobile communications and web-based technologies there are others which might especially
be beneficial in a public transport context:
169
Smart cards
Smart cards have been around for several years now. However, until recently they were not widely
used in transport. Smart cards enable customization of service delivery to individuals based on the
user´s needs, for example how a person prefers to use a ticket machine. They are commonly used to
store value (as cash replacements) and are therefore used in ticketing systems e.g. Oyster card in
London. Smart-card schemes now exist throughout Europe for transport and other applications. (In
the Netherlands a nationwide public transport smart card is introduced.) Future developments will
include wider use of vicinity cards (up to two metres range from the reader), and an increase in the
amount of information carried.
Verbal communication with information systems
This future technology will become available when computers will be able to translate human
speech. In other words, people will be able to communicate verbally with vehicles or information
screens.
Intelligent-agent technology
Intelligent-agent technologies can be used to create ambient intelligent infrastructures or
environments, in which people are immersed in networks of invisible but powerful communicating
technologies that can adapt themselves to the needs of individuals, and can serve them by taking
instruction and performing tasks. Agents are embedded in everyday objects e.g. people, vehicles,
infrastructure and buildings. The networks can provide personalized services and information based
on needs, context, habit, etc. Hand-held devices or personal wearable devices (e.g. watches and
bracelets) would communicate with wall-mounted displays. The networks are unobtrusive,
personalized, adaptive, anticipatory and most importantly they are designed to respond to the needs
of individuals. A “pervasive” intelligent environment can support ageing populations providing
independence and easy seamless access to services.
Roadmap of technologies to be used in public transport
170
ANNEX
171
172
SPEAKERS AND CHAIRS
BY SESSIONS
Gerhard Finking
Ingolf Schädler
Tomas Lagerwall
Mary Tovšak Pleterski
Reinhard Goebl
Bernd Marin
Jeroen Wals
Holly Jimison
Peter Saraga
Alexander Kollreider
Henning Seiding
Irina Odnoletkova
Jan Muehlfeit
Volker Adams
Silas Olsson
Dimitrios Tzovaras
Paul J.M. Havinga
Fiorella Marcellini
Didier Stricker
Wolfgang Zagler
Martin Litzenberger
Pekka Kahri
Maja Arnestad
Gerda Geyer
Uli Waibel
Harriet Finne-Soveri
Guus Broos
Péter Hanák
Antonio Santos
Heidrun Mollenkopf
Anna Pohlmeyer
George W. Leeson
173
Michael Huch
Luis Pablo del Arbol Perez
Maria Haritou
Minna Isomursu
Tomas Brusell
Luca Fanucci
John A. Waterworth,
Rafael De Andrés-Medina
Hartmut Streese
Claus Nielsen
Joachim Russ
Juha Teperi
Giulio Antonini
Thomas Børner
Jane Hendy
Barbara van den Linden
Nanna Skovgaard
Gerda Geyer
Kerstin Zimmermann
Georg Niklfeld
Isabella Buber-Ennser
Brigitte Krenn
Christian Menard
Barbara van der Linden
Sidsel Bjørneby
Beppie Spruit
Walter Hlauschek
Margrit Bossart
Luc de Witte
Antonio Mendes dos Santos
Lone Gaedt
Jan Gerrit Schuurman, Michiel Besters
Marjo Rauhala
Anne Sophe Parent
Olav Felbo
Graça Simões
Antonio Remartinez
Rahel Tschopp
174
Ulrike Schneider
Peter Enste
Bernd Schips
Laura Romeu Gordo
Juan Carlos Castrosín Gutierrez
Hubert Oesterle
Peter Rumm
Peter Levene
Nissim Darvish
Manfred Tscheligi
Onny Eikhaug
Jane Clemensen
Richard Curry
Urs Guggenbühl
Terry Young
Madeleine Starr
Dirk Elias
Jeroen Wals
Ger van den Broek
Chuck Parker
Marco Eichelberg
Ad van Berlo
Christian Wehrmann
Filippo Cavallo
Ben Knapp
Emilio Mordini
Ilse Kryspin-Exner
Helmut Hlavacs
Holly B. Jimison
Alvaro Fernandez
William Hatt
Urs Guggenbühl
Chris Flim
175
AMBIENT ASSISTED LIVING JOINT PROGRAMME
AAL JP:
THE FIRST CALL FOR PROPOSALS AAL-2008-1
The first call aimed at launching European collaborative projects providing innovative ICT based
solutions for elderly persons with identified risk factors and/or chronic conditions. The call
envisaged the development of new solutions with a holistic approach, which includes prevention,
management, support services and the social and socio-economic environment related to chronic
conditions.
Funded projects must have a clear European dimension with high relevance for and maximum
impact on the development of ICT. The call was published on 25 April 2008 and closed on 21
August 2008.
This list gives an overview on all 23 projects that are funded under the first call. All projects started
in 2009 and run between 30 and 36 months.
Please visit www.aal-europe.eu to learn more details and to catch the latest information on the
projects.
Total Funding: € 2.6 million
a2e2
Adaptive Ambient Empowerment of the Elderly
Coordinator: Ute Ritterfeld, University of Amsterdam, VUA (NL)
Partners: Amsta (NL), Hospital IT AS (NO), VTT Technical Research Centre of Finland (FI),
Mawell Ltd (FI)
a²e² stands for an innovative ICT solution designed to prevent or/and manage elderly individuals’
chronic diseases through an increase in physical activity, resulting in better physical and mental
health, ultimately improving the quality of life of its users.
Total funding: € 2.6 million
AGNES
User-Sensitive Home-based Systems for Successful Ageing in a Networked Society
Coordinator: John Waterworth, Umeå University (SE)
Partners: CanControls (DE), Research and Education Laboratory in Information TechnologiesAthens Information Technology (GR), Graz University of Technology (AT), Universidad Nacional
de Educación a Distancia (ES), ModernFamilies (AT), KMOP (EL), Onda Communication S.p.A.
(IT), Fundacion Instituto Gerontologico Matía (ES), Skellefteå Kommun (SE)
The vision is to provide a user-sensitive ICT-based home environment that supports a personcentric care process by detecting, communicating, and meaningfully responding to relevant states,
situations, and activities of the elderly person with regard to mild cognitive impairment or
dementia.
176
Total funding: € 1.4 million
ALADDIN
A Technology Platform for the Assisted Living of Dementia Elderly Individuals and their
Carers
Coordinator: Maria Haritou, NTUA (GR)
Partners: Aethia (IT), ATOS Origin (ES), Badalona Serveis Assistencials (ES), Psychiatric
Hospital Of Attica (EL), Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V.
(DE), Institute of Communication & Computer Systems (EL), The National Hospital for
Neurology & Neurosurgery (UK), Universita di Bologna (IT)
The aim of the project is to utilise state-of-the-art in ICT in order to develop an integrated solution
for the self-management of dementia patients, and develop innovative tools to support this
procedure. This solution can be conceived as an integrated platform enabling distant monitoring of
patient status and facilitating personalised intervention and adaptive care.
Total Funding: € 1.8 Million
AMICA
Autonomy, Motivation & Individual Self-Management for COPD patients
Coordinator: Luis Felipe Crespo, Universidad de Cádiz (ES)
Partners: Foundation for Biomedical Research Management of Cadiz (ES), Forschungszentrum
Informatik (DE), Institute of Communication and Computer Systems (EL), Innovaciones
Sociosanitarias S.L. (ES), MSC Gleichmann (ES), Vitaphone GmbH (DE)
AMICA aims at providing medical management and medical care to patients suffering from
Chronic Obstructive Pulmonary Disease (COPD) and to address these challenges by developing
and assessing long-term COPD management solutions based on innovative Information and
Communication Technologies.
Total Funding: € 1.3 Million
BEDMOND
Behaviour Pattern Based Assistant for Early Detection and Management Of
Neurodegenerative Diseases
Coordinator: Alberto Martínez, Fundación ROBOTIKER (ES)
Partners: AIT Austrian Institute of Technology GmbH (AT), Center for Usability Research and
Engineering (AT), Fundación Instituto Gerontológico Matía (ES), Meticube - Sistemas de
Informação, Comunicação e Multimedia, Lda. (PT), Ibernex Ingeniería (ES)
BEDMOND is an assistant for the health professional, a daily behaviour information provider to
early diagnose mild cognitive impairment (MCI) stages as a first step of neurodegenerative
diseases, focused in elderly people while living at home.
Total Funding: € 1.3 million
CAPMOUSE
Development of a Non-Invasive Capacitive Sensor Oral Mouse Interface for the Disabled
Elderly
Coordinator: Tomas Brusell, Brusell Dental AS (NO)
Partners: HMC International NV (BE), Pensionärernas Riksorganisation (SE), Lots Design (SE),
Stinct (SE)
With a non-invasive modus operandi, CAP MOUSE will use external capacitive sensors mounted
on a CAP MOUSE headset to scan tongue movement and feed the signal into a processing unit that
extracts and translates features from the signal into e.g. mouse clicks and commands of the
integrated Mobile Device, thereby replacing the keyboard, the remote control and other electronic
devices.
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Total Funding: € 1.7 million
CARE
Safe Private Homes for Elderly Persons
Coordinator: Ahmed Nabil Belbachir, AIT Austrian Institute of Technology GmbH (AT)
Partners: Budapest University of Technology and Economics, Biomedical Engineering Knowledge
Centre (HU), Oy Exrei Ab (FI), SensoCube GmbH (DE), Senioren Wohnpark Weser GmbH (DE),
Yrjö ja Hanna Ltd (FI)
CARE targets the automated recognition and alarming of critical situations (like fall detection)
using optical sensor and real-time processing while preserving the privacy and taking into account
system dependability issues, especially ensuring reliability, availability, security, and safety from a
holistic point of view.
Total Funding: € 2.2 million
CCE
Connected Care for Elderly Persons Suffering from Dementia
Coordinator: Dr. Ranjit Bassi, Building Research Establishment (UK)
Partners: Budapest University of Technology and Economics, Biomedical Engineering Knowledge
Centre (HU), Building Research Establishment (UK), Centrihealth (UK), Fraunhofer-Gesellschaft
zur Förderung der angewandten Forschung e.V. (DE), Hereward College (UK), Innomed Medical
Inc. (HU), MedCom GmbH (DE), Hungarian Association of Home Care and Hospice (HU),
Philips (NL), Peverel (UK), User Interface Design GmbH (DE)
The project supports the development of an open, standardised, integrated European platform to
deliver connected ICT-based assistive living solutions for the elderly.
Total Funding: € 2.0 million
DOMEO
Domestic robot for Elderly Assistance
Coordinator: Vincent Dupourque, Robosoft (FR)
Partners: Université Pierre et Marie Curie – Paris 6 (FR), Centre Hospitalier Universitaire de
Toulouse (FR), Országos Orvosi Rehabilitációs Intézet / National Institute for Medical
Rehabilitation (HU), Vienna University of Technology (AT), Budapest University of Technology
and Economics (HU), Meditech (HU), Thales Alenia Space (FR)
The project will design and demonstrate the technical efficiency and the medical relevance of an
open integration platform for eldercare robots configuration and deployment in real-world
environment and for everyday life requirements.
Total Funding: € 2.7 million
eCAALYX
Enhanced Complete Ambient Assisted Experiment
Coordinator: Mª Carmen Margelí, CETEMMSA (ES)
Partners: Telefónica Investigación y Desarrollo (ES), Instituto de Engenharia de Sistemas e
Computadores do Porto (PT), University of Plymouth Enterprise Ltd (UK), University of Limerick
(IE), Fundació Hospital Comarcal Sant Antoni Abat (ES), Fraunhofer Portugal (PT), Corscience
GmbH & Co KG (DE), Ev. Krankenhaus Witten GmbH (DE)
eCAALYX will develop an efficient AAL solution for several chronic conditions that can provide
reliable long-term and maintenance-free operation in non-technical environments, thus, ready for
real-world deployment.
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Total Funding: € 2.7 million
EMOTIONAAL
The Emotional Village: Integrated Preventive AAL Concept For the Rural Aging Society in
Europe
Coordinator: Dr. Hans-Otto Maier, BBRAUN Melsungen AG (DE)
Partners: Opsolution NanoPhotonics GmbH (DE), German Retail Federation/ EHV Hesse-North
e.V. (DE), University of Marburg (DE), University of Kassel (DE), Diaconia University of Applied
Sciences (FI), Vitaphone GmbH (AT), German Aerospace Centre (DE), Protestant University of
Applied Sciences (DE), Activesoft LTD (FI)
EMOTIONAAL specifically targets at elderly persons living in rural areas and offers them an
integrated seamless solution including social services and new technologies to support self care,
prevention and assistance to carry out daily activities, health and activity monitoring and enhances
safety and security.
Total Funding: € 1.4 million
H@H
Health@Home
Coordinator: Luca Fanucci, Consorzio Pisa Ricerce (IT)
Partners: Caen Aurelia Space (IT), Caribel Programmazione Srl (IT), Centro Andaluz de
Innovación y Tecnologías de la Información y las Comunicaciones (ES), Consorzio Pisa Ricerche
(IT), Fondazione Gabriele Monasterio (IT), Mediasoft Ltd (SI), Hospitales Universitarios "Virgen
del Rocío" (ES), Zdravstveni dom Koper (SI)
The H@H addresses elderly citizens affected by Chronic Heart Failure (CHF), providing them
with wearable sensor devices for monitoring of cardiovascular and respiratory parameters and, at
the same time, enabling the medical staff to remotely supervise their situations and taking actions
by involving public/private healthcare organizations.
Total Funding: € 0.9 million
Happy Ageing
A Home Based Approach to the Years of Ageing
Coordinator: Fiorella Marcellini, Istituto Nazionale di Riposo e cura per Anziani V.E. II (IT)
Partners: Fundació Privada Cetemmsa (ES), Speed Automazione Srl (IT), Global Security
Intelligence Limited (UK), AB.ACUS SRL (IT), Institute of Sociology, Hungarian Academy of
Sciences (HU), The Association of Catholic Organisations of Senior Citizens in the Netherlands
(NL)
The HAPPY AGEING project approaches main limitations due to chronic diseases, low vision or
malnutrition and dehydration and manages the individual needs of dietary control, safety and
wellbeing. The HAPPY AGEING system will be composed of three modules, including a lifestyle
monitor for recording main activities, a navigation assistant to support user’s mobility in close
environment and a personal assistant to support performing distinct actions.
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Total Funding: € 2.5 million
HELP
Home-based Empowered Living for Parkinson’s Disease Patients
Coordinator: Luis Pablo del Arbol Perez, Telefonica Investigacion y Desarrollo (ES)
Partners: Hahn-Schickard-Gesellschaft für angewandte Forschung e.V. (DE), Nevet Ltd (IL),
Mobile Solution Group GmbH (DE), SALIWELL Ltd (IL), Telefonica Investigacion y Desarrollo
Sociedad Anonima Unipersonal (ES), Telecom Italia S.p.A. (IT), University and Hospital of
Palermo (IT)
The project integrates a complex system that dynamically monitors and treats Parkinson’s Disease
patients. The system comprises a non-invasive intra-oral drug delivery device, a pump to deliver
rescue medication, a PAN (Personal Area Network) to gather user’s environment information, a
telecommunication and services infrastructure to transfer information between the user and an
automated system and a remote point-of-care unit to supervise the patients.
Total Funding: € 1.2 million
HERA
Home Services for Specialised Elderly Assisted Living
Coordinator: Heidrun Häfele, Telekom Austria TA AG (AT)
Partners: Alcatel Lucent Deutschland AG (DE), Forschungsinstitut des Roten Kreuzes (AT),
DIAGNOSTIC AND THERAPEUTIC CENTER OF ATHENS- "HYGEIA" SOCIETE
ANONYME (GR), Paris Descartes University (FR), SingularLogic S.A (GR), SOLINET GmbH
Telecommunications (DE)
The HERA project aims at providing a platform with cost-effective specialised assisted living
services for the elderly people suffering from mild Alzheimer or cardiovascular diseases with
identified risk factors, which will significantly improve the quality of their home life, extend its
duration and at the same time reinforce social networking.
Total Funding: € 1.5 million
HMFM
Hear Me Feel Me - Compensating for Eyesight with Mobile Technology
Coordinator: Minna Isomursu, Technical Research Centre of Finland (FI)
Partners: Fundación ROBOTIKER (ES), Organización Nacional de Ciegos Españoles (ES), Nokia
Corporation (FI), ToP Tunniste Oy (FI), Caritas Foundation (FI), Finnish Federation of the
Visually Impaired (FI), Oulun 6. Joutsen apteekki (FI), National Center for Scientific Research
"Demokritos" (GR)
The HMFM project explores services related to medication and medicine related information and
services, and to health monitoring and diet information. Enabling technologies for the services will
be mobile devices and near field communication (NFC) technology.
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Total Funding: € 1.1 million
HOPE
Smart Home for Elderly People
Coordinator: Dimitrios Kilias, RTEL SA (GR)
Partners: Unita Operativa Geriatria & Laboratorio di Recerca Gerontologia-Geriatria - IRCCS
Casa Sollievo della Sofferenza, San Giovanni Rotondo (IT), CETEMMSA Technology Centre
(ES), Andalusian Centre of Innovation, Information and Communication Technologies (CITIC
Foundation) (ES), KMOP Organization (GR), Integrated Information systems SA (GR), TRACS
SRL (IT), FORUS SRL (IT)
The Hope project addresses elderly people that suffer from Alzheimer’s disease to achieve a richer
lifestyle. An ICT system will enable persons to perform activities they were not able to do before
and which are important for their daily personal life. The proposed system provides a basis for
integrating further services, e.g. control of the home environment.
Total Funding: € 1.3 million
IS-ACTIVE
Inertial Sensing Systems for Advanced Chronic Condition Monitoring and Risk Prevention
Coordinator: Paul Havinga, University of Twente, CTIT (NL)
Partners: University Hospital Elias (RO), Inertia Technology (NL), Northern Research Institute
Tromsø (NO), Norwegian Centre for Telemedicine, University Hospital of North Norway (NO),
PROSYS PC (RO), Roessingh Research & Development (NL)
The IS-ACTIVE project emphasises the role of the home as care environment, by providing realtime support to patients in order to monitor, self-manage and improve their physical condition
according to their specific situation. The project addresses all development phases of a prototype
wireless sensing platform, from hardware platforms and software packages to algorithms and user
interfacing and aims to introduce the platform 2 years after the project end.
Total Funding: € 1.8 million
PAMAP
Physical Activity Monitoring for Aging People
Coordinator: Didier Stricker, Deutsches Forschungszentrum für Künstliche Intelligenz GmbH (DE)
Partners: Foundation Alfred de Rothschild (FR), Intracom Telecom S.A. (EL), Trivisio Prototyping
GmbH (DE), Université de Technologie de Compiègne (FR)
PAMAP will develop an unobtrusive and fully mobile system that enables the accurate monitoring
of the physical activities of aging people. The system will be based on a set of tiny MEMS sensor
units and dedicated software for professional and private use. It will rely on a sounded biomechanical model of the human body, measure accurately the motions and efforts of the upper and
lower limbs, thanks to an appropriate parameterization.
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Total Funding: € 2.2 million
REMOTE
Remote Health and Social Care for Independent Living of Isolated Elderly with Chronic
Conditions
Coordinator: María García Robledo, SIEMENS S.A. (ES)
Partners: Fraunhofer Gesellschaft zur Förderung der angewandten Forschung e.V. (DE), Fundación
para la Investigación Médica Aplicada (ES), Foundation for Research and Technology - Hellas
(EL), MEDEA SRL (IT), Netscouts gemeinnuetzige GmbH (DE), Norwegian Centre for
Telemedicine (NO), Ortholine LTD (IS), Saliwell Ltd. (IS), TSB Soluciones S.A. (ES),
Universidad Politecnica de Madrid (ES)
REMOTE will advance the Software Architecture in fields of tele-healthcare by enhancing the
elderly’s home with audio-visual, sensor/motoric monitoring and automation abilities to trace vital
signs, activity, behaviour and health condition, and detect risks and critical situations, as well as
provide, effective and efficient support at home.
Total Funding: € 1.8 million
RGS
Rehabilitation Gaming System
Coordinator: Dr. Paul Verschure, Universitat Pompeu Fabra (ES)
Partners: Fundación Privada Tic I Salut (ES), Guger Technologies OEG (AT), University Hospital
Düsseldorf, Heinrich-Heine-Universität Düsseldorf (DE), Hospital del Mar i de la Esperança (ES),
Hospital Vall d'Hebron (ES), Tyromotion GmbH (AT)
The Rehabilitation Gaming System consortium will develop and test a virtual reality based system
that will allow an elderly person who suffered a stroke, to take advantage of a novel ICT based
product to manage their chronic condition. RGS deploys an individualized and specific deficit
oriented training that combines movement execution with the observation of a correlated action by
virtual limbs that are displayed in a first-person perspective.
Total Funding: € 2.3 million
ROSETTA
Guidance and Awareness Services for Independent Living
Coordinator: Irek Karkowski, TNO Defence, Security and Safety (NL)
Partners: Avics B.V. (NL), CPS Europe BV (NL), EATON ELECTRIC bv (NL), FraunhoferGesellschaft zur Förderung der angewandten Forschung e.V. - Institute ESE (DE), I+ S.r.l. (IT),
Landsbond Christelijke Mutualiteiten (BE), Novay (NL), TNO Defence, Security and Safety (NL),
Vilans (NL), VU medisch centrum (EMGO Instituut) (NL), Westpfalz-Klinikum GmbH (DE),
Stichting Zorgpalet Baarn-Soest (NL), CIBEK technology + trading GmbH (DE)
ROSETTA will help community dwelling people with progressive chronic disabilities (i.e.
Alzheimer’s Disease and Parkinson’s Disease) to retain their autonomy and quality of life as much
as possible and to support their (in)formal caregivers by developing and providing an ICT system
that offers activity guidance and awareness services for independent living.
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Total Funding: € 0.7 million
SOFTCARE
Kit for Elderly Behaviour Monitoring by Localisation Recognition and Remote Sensoring
Coordinator: Irene Larroy, Centre de Recerca i Investigatió de Catalunya S.A. (ES)
Partners: Capex Health Ltd. (UK), Forschungsinstitut des Wiener Roten Kreuzes (AT), Ceit Raltec
(AT), Meshworks Wireless Ltd. (FI)
The proposed SOFTCARE technology will use behavioural patterns recognition and ZIGBEE
sensing nodes to create an integral system for home monitoring which will greatly expand upon
existing home-based health monitoring system, as it will take into account more than one chronic
condition.
Statistics of the first AAL Call
The high participation of commercial partners and user organisations in call 1 fully meets the
programme's objectives.
Participating Organizations
Type of organisations (N=958)
7%
16%
11%
University
Research Organisation
9%
19%
SME
Large enterprise
User Organisation
Other
38%
183
The first call for proposals of the AAL JP was well accepted by the AAL community: 117
transnational project proposals involving 958 organisations of all 23 AAL partner states were
received.
Number of Partners per Country
184
BENEFIT PROJEKTE 2008 BENEFIT PROJECTS FUNDED IN 2008
Open Call 2008
Austrian Research Centers GmbH – ARC
Avatars@Home: Avatar-Interfaces for the Assistive Home
("face-lifting" user dialogues in smart home environments)
Diese Studie soll Wissen über die Akzeptanz und Eignung von fotorealistischen Avataren zur
Gestaltung der Benutzerschnittstelle von AAL Umgebungen generieren. Eine Usability Studie
sowie die Evaluation dieser Gestaltungsmöglichkeit mit BenutzerInnen (60-75 Jahre, ohne und mit
Diagnose MCI) wird qualitative und quantitative Daten liefern, um zukünftig Smart Homes
benutzerInnenfreundlicher und attraktiver zu gestalten.
This study aims to generate new knowledge about the effects of using photo-realistic avatars as
part of the user interfaces for Ambient Assisted Living environments. A usability study and
evaluation of the acceptance and suitability of users between the ages of 60-75 with and without
diagnosed Mild Cognitive Impairment will produce qualitative and quantitative data to make smart
home environments more usable and accepted by the target group.
Projektpartner:
CURE – Center for Usability Research and Engineering
Avatars@Home
Stimulierungsprojekt
The Compliers Group Austria GmbH
Bedienbarkeit und Akzeptanz von Compliance Messgeräten
zur kontinuierlichen ärztlichen Betreuung und Verlängerung
der Verbleibquote von Senioren in häuslicher Umgebung
Anwendungsorientierter Einsatz innovativer IKT Geräte erlaubt zur Therapie die ComplianceMessung verbunden mit entsprechender Betreuungsdienstleistung. Der erwartete Nutzen für
SeniorInnen als End-AnwenderInnen besteht in einer kontinuierlichen ärztlichen Betreuung im
häuslichen Umfeld, einer Verlängerung der aktiven Lebensphase, der Verbleibquote in häuslicher
Umgebung sowie Unterstützung in der hilfsbedürftigen Phase.
For the first time, an innovative RFID/NFC-based information technology system allows the
correlation of real time medication compliance measurements and online transferred data
outcomes. This is important to maintain continuous health care support at home for elderly,
functionally disabled patients with chronic diseases giving them the opportunity to stay in their
familiar surroundings. The system also assists family members and nursing services.
Projektpartner:
Wiener Gebietskrankenkasse
Compliance Betreuung
Stimulierungsprojekt
185
IU - Integratives Umfeld für Abteilung Bauphysik und Bauökologie, Institut für
Architekturwissenschaften, Fakultät für Architektur und
aktives Altern
Raumplanung, Technische Universität Wien
Stimulierungsprojekt
Integrative räumlich-technologische Rahmenbedingungen
für aktives Altern
Die wissenschaftlichen Grundlagen für ein aktives Altern im gewohnten Wohnumfeld unter
Einbeziehung intelligenter Technologie werden erarbeitet. Momentan gibt es keine aktuelle
Untersuchung, welche Wohnumfeldrahmenbedingungen erfüllt sein müssen, dass technologische
Interventionen sinnvoll zum Einsatz kommen können.
The proposed research aims at the understanding of the interrelation between people, intelligent
environments, and smart technologies as an indispensible prerequisite for the successful integration
of information and communication technology towards the accommodation of active ageing. The
research involves: i) the collection and analysis of pertinent data concerning risk levels and
occurrence of accidents; ii) specification of integrated solutions that combine a) intelligent spatial
and architectural factors; and b) smart technological tools and devices in order to ensure and
prolong safe, secure, and active living and ageing conditions in familiar surroundings.
Austrian Research Centers GmbH – ARC
/ Bereich Biomedical Engineering
Stimulierungsprojekt
Evaluation of a Personal Drug Reminder
Im Rahmen des Projekts PDR-Eval wird die Akzeptanz und die Nutzbarkeit einer Mobiltelefonbasierten Anwendung (Verwendung von NFC-Technologie) zur Unterstützung von älteren
Menschen bei der Einnahme von Arzneimitteln evaluiert werden.
Within the project PDR-Eval, we want to evaluate the acceptance and usefulness of a mobile phone
based application using NFC technology in order to enhance the compliance of drug intake for
elderly people.
Projektpartner:
VAMED KMB
PDR-Eval
WPU Wirtschaftspsychologische Unternehmensberatung GmbH
Entwicklungstendenzen in den Wirkfeldern des aktiven
Alterns und des resultierenden Konsumverhaltens bis zum
Jahr 2020
Diese Foresight Study zeigt Entwicklungstendenzen bei den Wirkfeldern des aktiven Alterns (u.a.
Mobilität, Bequemlichkeit, Sicherheit, Freizeit, Networking, Fitness, Haushalt, Gesundheit) und
daraus resultierend Änderungen im Konsumverhalten bezogen auf das Jahr 2020 auf. Diese Studie
realisiert das Ergebnis in einem dreistufigen Szenario-Workshopprozess mit „aktiven
SeniorInnen“, Vertreterinnen der Wirtschaft und Wissenschaft.
This Foresight Study will make predictions about the scope in the main fields (mobility,
convenience, security, spare time, networking, fitness, household, and well-being) of active ageing
in 2020 based on the paradigm of “Ambitious Ambient Living”. It will identify the main
development tendencies. Results are created in a three-step workshop process with representatives
from economy, science and senior citizens by methods using scenario techniques and innovation
management.
Tendenzen 2020
Stimulierungsprojekt
186
Austrian Research Centers GmbH – ARC
WAAL 2009
Stimulierungsprojekt
Workshop-Reihe AAL 2009
In der Workshopreihe WAAL 2009 werden in vier Workshops und einer Podiumsdiskussion
aktuelle Fragestellungen zur Entwicklung und Anwendung von AAL-Technologien behandelt. Die
Themen sind: „Soziale Interaktion älterer Menschen“, „IKT-gestützte häusliche Pflege“, AAL in
der institutionellen Pflege und der „Business Case AAL“. Zu den Workshops werden die
entsprechenden Stakeholder eingeladen, u.a. auch Menschen im Alter und deren
Interessensvertretungen.
A series of workshops and panel discussions will cover actual topics on the development and
application of AAL-Technologies. The subjects are: “social interaction of elderly people”, “ICT
based home care”, “AAL within institutionalised care” and “the business case AAL”. Relevant
stakeholders will be invited to each of the workshops, including elderly people and representatives
of their interests.
Institut für Computertechnik, TU Wien
AdapTive scenario recogniTion for Emergency and Need
Detection
Ziel des Projekts ATTEND ist die Erforschung und prototypische Entwicklung eines Systems, das
alten Menschen länger eine autonome und/oder betreute Lebensführung in der eigenen Wohnung
erlaubt. Es handelt sich um ein intelligentes, adaptives Netzwerk aus Sensoren. Diese Sensoren
beobachten und klassifizieren das Verhalten der BenutzerInnen mit kombiniert statistischen und
symbolischen Ansätzen und alarmieren bei Problemen eine Betreuungseinrichtung.
The aim of the project ATTEND is the investigation and prototypical development of a
comprehensive system which allows elderly persons to live longer autonomously and/or to be
cared for in their own flat. The system comprises an intelligent, adaptive network of sensors. The
sensors observe and classify the user’s behaviour utilising combined statistical and symbolic
approaches in order to trigger an alarm in case of detected problems.
Projektpartner:
CEIT RALTEC
ATTEND
Humanressourcenprojekt
2. Ausschreibung / 2nd Call for Proposals
TELEKOM AUSTRIA TA AG
AID
Kooperatives Forschungs- und AID - Interactive Awareness Displays for Elderly People
Entwicklungsprojekt
Das Projekt AID hat es zum Ziel, ein zentrales Kommunikationsterminal für den Heimbereich
älterer Menschen in Form eines Touchscreens zu entwickeln, um die Kommunikation mit
Angehörigen
zu
erleichtern/fördern.
AID
integriert
verschiedene
multimediale
Kommunikationskanäle (Display zu Display, PC zu Display, Mobil zu Display) und soll
Benutzungsbarrieren abbauen und den Zugang zu ICTs erleichtern.
AID’s project aim is to develop a communication terminal for elderly people using a touch screen
interface to facilitate access to communication services. AID displays are placed in the home
environment of the target group and are designed to stimulate communication with relatives and
friends. AID integrates text messages, e-mail, and display to provide communication as well as
information services.
Projektpartner:
USECON
Forschungsinstitut des Roten Kreuzes
CURE – Center for Usability Research and Engineering
187
CogVis Software and Consulting GmbH
MuBisA
Kooperatives Forschungs- und Multivariate Bildfolgenerkennung für selbstbestimmtes
Entwicklungsprojekt
Altern
Das Ziel dieses Entwicklungsprojektes ist die Einführung der robusten bildbasierten
Ereigniserkennung im Heimbereich. Verschiedene Methoden der Bilderkennung werden zur
Unterstützung der Routinetätigkeiten des täglichen Lebens für unselbständige Menschen
zusammengeführt. Es wird ein System entwickelt, dass ein breiteres Spektrum an
Sicherheitsfunktionen im Vergleich zu bestehenden Systemen bietet. Dieses System beinhaltet eine
rein visuelle und selbständige Sturzerkennung für Patienten, die frühzeitige Erkennung von
Bränden in Wohnungen sowie eine Kontrollfunktion für die Medikamenteneinnahme. Damit kann
die Lebensqualität von alten, kranken oder dementen Menschen erheblich verbessert werden und
ihnen möglichst lange selbständiges Leben ermöglicht werden.
The goal of this project is a reliable and automated computer vision system to enable an
independent lifestyle for the elderly and disabled. In contrast to other projects, the system relies
solely on computer vision techniques. The daily lives of the people involved will not be affected
and it overcomes many problems of existing systems. The main goal is the robust detection of
elderly people who fall. Since the detection set-up consists basically of IP-based cameras and a
central storage and calculation server, the system is open and flexible in relation to other
applications: fire, smoke and water detection and assistance for medication are introduced in a
second step.
Projektpartner:
e-nnovation IT-Systeme GmbH
TU Wien – PRIP
Fond Soziales Wien/IT
AKH Wien
Samariterbund Wien
BEST AGE Consulting GmbH und FH Technikum Wien
Ist ein „Haus der Generationen“ – Drehscheibe der Anbieter
und Nachfrager intergenerativer IKT Produkte - sinnvoll
und machbar?
Das „Haus der Generationen“ führt KundInnen der BEST AGER Generation (aktive ca. 60 bis 75 –
Jährige) und IKT-Anbieter zusammen: Damit erhalten die BEST AGER jene Produkte, die sie
wirklich wollen und die Anbieter können ihre IKT Produkte so gestalten, dass sie von den BEST
AGERN gerne akzeptiert werden: eine echte WIN - WIN Situation für alle. Die Sinnhaftigkeit und
Machbarkeit dieser Idee wird in der gegenständlichen Studie untersucht.
The “House of Generations” pools the interests of “BEST AGERS” (active people aged approx.
from 60 to 75) and ICT-vendors. The outcomes are products which really match the needs of
“BEST AGERS” (demanding but loyal customers) as well as - for the entrepreneurs - substantial
increase of ROI: a win-win situation for all stakeholders. The feasibility of this idea is investigated
in a comprehensive study.
GEN_TT
Stimulierungsprojekt
188
Institut für Erziehungswissenschaften,
Forschungsschwerpunkt Innsbruck Media Studies,
Leopold Franzens Universität Innsbruck
Stimulierungsprojekt
Lebensqualität im Alter – Grundlagen und Anwendungen
des Lernens und Lebens mit assistiven Technologien
Die internationale Tagung Lebensqualität im Alter befasst sich mit Grundlagen und Anwendungen
des Lernens und Lebens mit vernetzten assistiven Technologien. Dazu werden auch interessierte
Einzelpersonen und Vertreter von Seniorenverbänden, Daseinsversorgern, Pflegeheimen,
Beratungsstellen, Verwaltung, Wissenschaftler und Wirtschaftsunternehmen eingeladen.
The international conference deals especially with the basics and application of learning and living
with connected assistive technology. It addresses interested individuals, representatives of senior
alliances, local providers, nursing homes, information centres, administration, research and
companies.
Projektpartner:
Meditrainment Consulting GmbH
Lebensqualität im Alter
LifeTool gemeinnützige GmbH
Machbarkeitsstudie
über
ein
interdisziplinäres
Kompetenzzentrum „IKT-Lösungen für Menschen im Alter“
(Arbeitstitel, z.B. auf LOIs „BTS- Beratungsstelle
Technologie für SeniorInnen“)
Menschen im Alter sind ein Wachstumsmarkt. Dieser gestaltet sich allerdings auf Grund der
Vielzahl an unterschiedlichen Bedürfnissen sehr heterogen, was wiederum die erfolgreiche
Entwicklung von zielgruppenspezifischen Angeboten erschwert. Ziel ist es daher, das Konzept
eines interdisziplinären Kompetenzzentrums mit Schwerpunkten in der Forschung, Entwicklung,
Beratung, Evaluation und Distribution von IKT-Lösungen für Menschen im Alter einer
Machbarkeitsprüfung zu unterziehen.
Elderly People are a growing market in which requirements greatly differ. Heterogeneous market
needs result in difficulties for successful application developments for these specific target-groups
of the elderly. This identifies the need for the concept of an interdisciplinary competence centre
focussed on research, development, consultancy, evaluation and distribution around ICT-solutions
for elderly people and requires a feasibility study to be undertaken.
Projektpartner:
• Kompetenznetzwerk Informationstechnologie zur Förderung
der Integration von Menschen mit Behinderungen
• Syncare Consulting GmbH
MiAZen
Stimulierungsprojekt
189
Brigitte Eisinger, Consultants for IT & telecommunication
Windows Wide Open – Gegen die Vereinsamung älterer
Menschen - MACHBARKEITSSTUDIE
WindowsWideOpen (WWO) ist ein internetbasierendes audiovisuelles Kommunikationssystem
für Ältere, das audiovisuell und interaktiv in beide Richtungen stattfindet und altersgerecht ohne
Maus und Tastatur bedient wird. Die Machbarkeitsstudie beschreibt das WWO-System in
detaillierten Funktionen und untersucht Akzeptanz und Bedürfnisse bei der Pflege und Betreuung
in den eigenen vier Wänden.
WindowsWideOpen (WWO) is a web-based, audiovisual communication system supporting
elderly people, working audio visually and interactively in all aspects. It can be handled easily
without using a computer mouse or a keyboard. The feasibility study describes the WWO system
in its detailed features and examines the acceptance of and the patient’s needs during attendance in
the privacy of their homes.
Projektpartner:
Volkshilfe Österreich
coop 50 plus
Windows Wide Open
Stimulierungsprojekt
3. Ausschreibung / 3rd Call for Proposals
Universität Wien,
Institut für Distributed and Multimedia Systems
Kooperatives Forschungs- und Ambient Assisted Shared Living
Entwicklungsprojekt
Das Ziel des Projektes AMASL ist es, ein professionelles, multimediales Kommunikationssystem
für alleinlebende, ältere Menschen zu erstellen. Ältere Menschen sollen möglichst realistisch in das
Leben ihrer möglicherweise entfernt lebenden Verwandten optisch und akustisch integriert werden,
so als ob es sich um denselben Haushalt handeln würde.
The proposed project AMASL aims to create a professional multimedia communication system for
elderly people currently living alone in their homes with no one to talk to. Elderly people should
experience the realistic impression of living in the same household as their relatives who possibly
live far away.
Projektpartner:
Kapsch Carrier Com KCC
Forschungsinstitut des Roten Kreuzes
AMASL
190
iPodion GmbH
EinfachWir
Kooperatives Forschungs- und EinfachWir – Das Mitmach WEB
Entwicklungsprojekt
Das eingereichte Projekt wird Interfaces und Benutzungsparadigmen für EinfachWir entwickeln.
EinfachWir wird ein hochinteraktives, zielgruppengerechtes und zielgruppengetriebenes
SeniorInnenportal, das von AnwenderInnen selbst gestaltet und mit Leben erfüllt wird; zusätzlich
stehen qualifizierte Experteninformationen zur Verfügung. Das Portal wird so gestaltet, dass es
auch für computerunerfahrene Menschen und Personen mit kognitiven und körperlichen
Einschränkungen einfach verwendbar ist.
The proposed project will develop interfaces and paradigms for the EinfachWir portal. EinfachWir
will be a highly interactive, user-oriented, and user-driven web-portal for senior citizens, the
content of which will be created by the users themselves; in addition, professional information will
be provided by experts. The design and layout of the portal will be shaped in such a way that it can
be easily used by people with little or no experience with computers and people with a cognitive or
physical handicap.
Projektpartner:
querform.at - projekte & design OG
TU Wien, Institut ‚integriert studieren‘
FH Technikum Kärnten Gemeinnützige Privatstiftung (FHK)
Health@Home
Kooperatives Forschungs- und Heimbasiertes Krafttraining für ältere Personen als
Entwicklungsprojekt
Fortsetzung der Herz-Kreislauf Rehabilitation
Das Projekt umfasst die Entwicklung und Erprobung eines innovativen, altersgerechten,
kraftbasierenden Trainingssystems für den Heimbereich zur Erhaltung und Steigerung der
Lebensqualität älterer Personen. Ein Forschungsprototyp soll in einer Pilotstudie mit 70-90 EndAnwenderInnen getestet werden, um die Einsetzbarkeit des Systems nachzuweisen und überprüfen
zu können.
This project consists of the development and testing of innovative, age-based, strength-based
training systems for home usage to maintain and improve the quality of life of elderly persons. An
R&D prototype is planned to be tested in a pilot study with 70-90 end-users to verify and validate
the implementability of the system.
Projektpartner:
Institut für Bewegungstherapie Graz Eggenberg (IFB)
Ilogs – information logistics GmbH (iLogs)
Austrian Research Centers GmbH (ARC)
191
CEIT RALTEC GmbH
VITALIshoe
Kooperatives Forschungs- und IKT-unterstütztes smart-textile basiertes System zur
Entwicklungsprojekt
Aktivitätssteigerung und Sturzprophylaxe
Im Rahmen des Projektes VITALIshoe wird für den älteren Benutzer ein smart-textilebasiertes und
computer-gestütztes System zur eigenständigen Balance-, Sturzrisiko- und Aktivitätskontrolle und
dazugehörigem Trainingprogramm realisiert, das eine gezielte und professionell unterstützte
Steigerung des physischen Aktivitätslevels, mit den dadurch verbundenen positiven Konsequenzen
auf den Lebensalltag, zur Folge hat.
Within the project VITALIshoe, a computer and smart textile based system will be developed that
allows the unassisted control of balance, risk of falls and activity levels, and provides the user with
an appropriate exercise program. This project aims to increase the physical level of activity in a
well directed and professional way and thereby enhances the quality of daily living for elderly
people.
Projektpartner:
MASSIVEART Gmbh
FH Technikum Wien
BEKO Engineering & Informatik AG
VitaSmart
Kooperatives Forschungs- und Smart Home Companion für Vitalmonitoring
Entwicklungsprojekt
Generelles Ziel von VitaSmart ist die Entwicklung von SmartyVital, einem Smart Home Companion
für Vitalmonitoring. Aufbauend auf dem Prototyp des Smart Home Centers von BEKO zielt
SmartyVital auf eine kontextuelle Personalisierung und situationsgetriebene Unterstützung von
Smart Home End-AnwenderInnen im Bereich Vitalmonitoring.
In the project VitaSmart, our aim is the development of SmartyVital, a Smart Home companion for
vital monitoring. Based on the prototype of BEKO’s Smart Home Centre, we are developing a
contextualised personalisation model to support the elderly.
Projektpartner:
Research Studios Austria Forschungsgesellschaft mbH
– Studio Smart Agent Technologies
Institut Sports-Engineering & Biomechanics an der
Fachhochschule Technikum Wien
Stimulierungsprojekt
Durchführbarkeitsstudie zur Entwicklung des idealen
Trainings- und Analysegerät zur Sturzprävention bei älteren
Menschen
Der Fokus des gegenständlichen Projektes liegt in der Verfassung eines Konzeptes für ein ideales
Individualtrainings- und Analysegerät zur Sturzprävention älterer Menschen, unter
Berücksichtigung der bisherigen Erkenntnisse auf dem Gebiet der Analyse koordinativer
Fähigkeiten. Parameter zur Validierung der Körperbalance, als wesentlicher Aspekt der
Sturzprävention, und die dafür geeignete Messtechnik zur Erfassung, sollen definiert werden.
The main focus of this project is to create a concept for an ideal analysis and training device which
improves body stability and prevents elderly people from falling. Therefore the parameters for a
validation of the body balance must be defined and methods to measure those will be screened. In
addition, the concept will contain considerations on how technical equipment meets the special
needs of elderly people, e.g. design, safety systems.
Balance 60+
192
Universitätsklinik für Neurochirurgie,
Medizinische Universität Wien
Psychologische Einflussfaktoren auf das Nutzungsverhalten
und die Akzeptanz von Gerontotechnik am Beispiel der
tiefen Hirnstimulation
Das Projekt soll die psychologischen Einflussfaktoren auf Akzeptanz und Nutzungsverhalten eines
Patientensteuergerätes vor und nach einem Training bei älteren Menschen mit tiefer
Hirnstimulation evaluieren. Das Gerät erlaubt den Patienten eine aktive Beeinflussung ihrer
Therapie, wird aber in der Praxis nur wenig genutzt. Durch Einbeziehung der Psychologie soll die
Schnittstelle Alter und Technik optimiert werden.
The current project aims to evaluate the psychological factors underlying the acceptance and
usability of a therapy controller prior to and after patient education. Elderly parkinsonian and
tremor patients use this controller after deep brain stimulation allowing fine tuning of
neurostimulation. However, in practice, patients rarely use this device. The overall goal is to
include psychology at the interface between ageing and technology.
Projektpartner:
Institut für klinische, biologische und differentielle Psychologie,
Universität Wien
Psychologie und
Gerontotechnik
Humanressourcenprojekt
Gierlinger Pucher GesbR
Voice-over-IP-Widget
Konzeptinitiative
Browser basierte Internettelefonie für soziale Netzwerke
Ziel dieses Projektes ist die Konzeptionierung und Entwicklung einer browserbasierten
Telefonielösung (Voice over IP (VoIP) Telefonie), welche ohne Installation von Software die
Sprachkommunikation von einer Webseite aus ermöglicht. Da diese Applikation in jegliche
Webseite eingebunden werden kann, ist die Integration in Soziale Netzwerke ein angestrebtes Ziel.
The aim of this project is the conceptual design and development of a browser-based telephony
solution (voice over IP (VoIP) telephony) offering voice communication from a web page without
the installation of software. As this application might be embedded in any web page, the
integration in social networks is an aspired aim.
193
PROJECTS PRESENTED AT THE YOUNG
RESEARCHERS' AND PHD WORKSHOP
Leopold Hayer1
Young Researcher / PhD student
Project
AAL Solution for Night Monitoring in
Nursing Homes
In order to support the monitoring and improve
Aquilano, Michela
the quality of assistance in nursing homes, an
ARTS Lab, Scuola Superiore Sant'Anna per gli
AAL system, based on a ZigBee sensor was
Studi Universitari e di Perfezionamento, Pisa
developed and tested. Following benefits of this
Italy
AAL solution came out: modularity, low
invasivity, reliability of the recognized events,
easiness to be used from sociomedical staff.
Casattenta (Aware Home)
The aim of “Casattenta” (Aware Home) project
is to build a wireless network that integrates
Bordoni, Alberto
ambient sensors with biomedical sensors, in
The Laboratory for ICT Technologic Transfer
order to monitor critical situations in houses
(T3Lab) in Bologna
inhabited by elderly people. Moreover, the
Italy
system is aimed at providing communication
between elderly people and the outside world by
Internet video-chat.
1
Leopold Hayer holds a Master's degree in sociology, and is library and information expert.
194
Tele-Monitoring Tools for the Improvement
of Assistance in Alzheimer's Disease
The research project seeks to develop new
technologies for the classification of the
different stages in Alzheimer’s disease. The
expected results are in brief: a) the improvement
of the early diagnosis of Alzheimer’s disease
and of the treatment provided by health care
professionals; b) the possibility of Alzheimer’s
patients to stay at their homes as long as
possible through the help of tele-monitoring
devices; c) the upgrading of the assistance
provided to patients suffering from Alzheimer’s
disease in sociosanitary centres; and finally, d)
the improvement of patients’ and caregivers’
quality of life.
Mobile Phone Acceptance by Older People:
Building and Validation of a Theoretical
Model
In this work the adoption and use of mobile
phone by older people is investigated,
considering
both
utilitarian
(perceived
usefulness) and hedonic (enjoyment) constructs.
The findings show a significant influence of
intrinsic and extrinsic motivations on mobile
phone adoption. Particularly, older people think
that mobile phone is useful and increases selfactualization; it is still perceived as an alien
device, though, manifested in a strong need for
external support in its usage.
Buiza, Cristina
Instituto Gerontológico Matía - INGEMA,
Donostia - San Sebastián
Spain
Conci, Mario
Faculty of Cognitive Science, Trento
Italy
Cottone, Riccardo
The Laboratory for ICT Technologic Transfer
(T3Lab) in Bologna
Italy
Etxeberria, Igone
Instituto Gerontológico Matía - INGEMA,
Donostia - San Sebastián
Spain
Floeck, Martin
Institute of Automatic
University of Kaiserslautern
Germany
Control
Casattenta (Aware Home)
See project description above
(Bordoni, Alberto).
Tele-Monitoring Tools for the Improvement
of Assistance in Alzheimer's Disease
See project description above (Buiza, Cristina).
PAUL, the Personal Assistant Unit for Living
PAUL is a tablet-PC-based multi-purpose AAL
interface featuring VoIP communication, a
video entry phone, the control and visualization
(IAC), of the home automatic components, a web
browser. A background task is healthmonitoring by recording actvity and inactivity
patterns. Should unexpectedly large deviations
of the actual pattern be detected, an alarm will
be triggered.
195
Gulyás, Máté
Faculty of Electrical Engineering and
Informatics, Budapest University of Technology
and Economics
Hungary
Hamilton, Peter
Fachhochschule Technikum Wien
Austria
Heine, Thomas
Institute of Physical and Theoretical Chemistry,
Tübingen University
Germany
Helfenbein, Tamás
Department of Control Engineering and
Information Technology, Budapest University
of Technology and Economics
Hungary
Jagos, Harald
CEIT RALTEC, Schwechat
Austria
BPMA and DiScA: Blood Pressure Monitor
and Dietetic Scale & Recipe Book Assistants
The BPM Assistant helps the patients monitor
their blood pressure easily at regular intervals,
prevents false hypertension alerts, rules out the
white-coat hypertension, and improves the
compliance of the patients. BPMA allows also
remote monitoring and management which
enables the medical staff to adapt drug dosages
to the current condition of the patient. DiScA,
the dietetic scale and recipe book assistant
measures, calculates and keeps track the
nutrition contents of the consumed food with the
help of an electronic recipe book and the
nutrient tables of the ingredients, stored in a
PostgreSQL database.
Safe Private Homes for Elderly Persons
[CARE]
A biologically-inspired neuromorphic vision
sensor will be integrated in the Everon system
from EXREI for seamless analysis and tracking
of elderly persons' behaviour at home. This realtime information can be exploited for incident
detection, and instantaneous alarming the
concerned parties.
Netcarity
This contribution focuses on the state of the art
microsystems technology solutions for robust
fire detection as well as fall detection as piece of
a holistic AAL approach.
Modern Motion Sensor Development
The motion detection sensor which uses both
camera and infrared technology can more
robustly detect motion in indoor environments.
Using wireless technology sensor can send alert
signal and/or images to the user in case of
motion is detected. Due to the reliability, small
size, ease of application, low power
consumption and networking capabilities it can
be suitable for security, homecare and AAL
applications.
Development of a Wearable Measurement
System to Identify Characteristics in Human
Gait - eSHOE
The idea is to integrate a gait monitoring system
into a shoe insole. One of the projects superior
goals is to conclude, from the detected gait
parameters, the risk of falling among elderly
people.
196
Gerotechnological Aspects in Health Care:
on the Example of Patient Controllers for
Deep Brain Stimulation
The aim of the study is to discuss
gerotechnological issues on the example of DBS
Kaiser, Iris
Medical University of Vienna
controllers. The present study forms the initial
Austria
point for future studies that include the patient’s
perspective and points out possible usability
flaws of DBS controllers to create new impulses
for industrial design and to increase the use and
acceptance in patients.
On the Requirements Elicitation for Home
Care ICT Services
In the requirements elicitation process, endusers were involved using a holistic patient
model, the ICF (International Classification of
Functioning, Health and Disabilities). This
Klooster, Jan-Willem van 't
Telemedicine Group, Faculty of Electrical model reflects on the social aspects of health, as
Engineering, Mathematics and Computer it positions persons in their bio-psycho-social
Science, University of Twente, Enschede
context: it not only covers the status of the body
The Netherlands
functioning and structure, it also considers
activities and social participation. The model
also provides guidelines for using its
classification and aids in developing services for
the assessed subject through identifying
problems in the complete health status.
ICT for Independent Living
The research work is towards a service that can
provide senior citizens greater support towards
Konstantinidis, Evdokimos
Lab of Medical Informatics, Medical School of their independent living. The heart of this
the Health Sciences Faculty,
service is an integrated ICT platform which
Aristotle University of Thessaloniki
combines state-of-the-art cognitive exercises
Greece
against cognitive decline with physical activity
in the framework of an advanced ambient
assisted living environment.
Email Work Flow Management for the
Ageing Workforce
The aim of this project is to bring together the
research on e-mail productivity and workflows
with human-computer interaction research and
the development of assistive technology to
Krukowska, Marta
assist the ageing population. Main objectives
School of Computing, University of Dundee
include: identifying bottlenecks and barriers in
Scotland
the use of email workflow, supporting older
users through prediction using templates derived
from workflow analysis, developing an
appropriate email user environment and
evaluating the developed system with people
from different age groups.
197
AAL Box: Improving Social Interaction of
the Elderly
The project aims to create a piece of equipment
called AAL box meant not only to monitor its
user’s health, but also to promote integration
Lablans, Martin
into social life and facilitate communication
Institut für Medizinische Informatik und
among existing and new contacts. For this
Biomathematik, Universitätsklinikum Münster
purpose, the device maintains communication to
Germany
relatives and friends as well as proposes
activities and events that help establishing more
intensive social contacts. These proposals take
into account the current medical condition, thus
adding to a healthier life.
Camera System for Personal Safety
This research work is about a closed circuit
television system in combination with a
biometrical algorithm for face recognition called
triple eye cam which is able to identify persons
Lazelberger, Erich
Austrian Institute of Technology GmbH
to support elderly people’s safety. The objective
Austria
is to realize a system comprising a biologicallyinspired stereo vision sensor, a smart camera, a
server connection, an infrared floodlight and a
pan/tilt unit for the biometrical identification of
persons.
Ambient Assisted Shared Living for the
Elderly (AMASL). Evaluating the User
Perspective.
A
Siscussion
about
Methodological and Ethical Issues
The aim of the interdisciplinary project is to
include elderly people into the lives of their
Lilgenau, Anneliese
relatives and friends. Technology should
Institut für Pflegewissenschaft,
therefore be used to create an Ambient Assisted
Universität Wien
Shared Living (AMASL) space. To evaluate the
Austria
technical solution of ambient assisted shared
living an extended field study will be carried out
over a few months to derive in depth results
about user acceptance and the effects of the
technical solution on well-being, social
integration and communication.
198
3D Surveillance System without Complex
Peripheral Hardware Based on a BioInspired Image Sensor Technology [CARE]
The dissertation deals with a new kind of image
sensor consisting of a pixel which combines a
Matolin, Daniel
Austrian Institute of Technology GmbH
temporal change detector with time-based
Austria
photo-measurement. The change detector
autonomously recognizes temporal changes of
illumination, which significantly reduces the
effort in application for person detection in the
observed scene.
Interoperability in Ambient Assisted Living
(AAL): Standardization of Sensor-Data
Based on ISO/IEEE 11073
This study shows that it is possible to apply the
standard to existing sensor-networks by
designing the agent with appropriate mapping
methods between manufacturer- and ISO/IEEE
Nieke, Philipp
Department of Biomedical Engineering, 11073
nomenclature.
Therefore
certain
University of Applied Science Technikum software-modules make the application of the
Vienna
standard independent from the sensors and
Austria
sensor data protocol. The flexible bodywork of
the designed agent allows its usage for specific
sensor networks from different manufacturers
without great effort, whereas the “onceimplemented manager” can be applied for any
ISO/IEEE 11073-10471 Independent Living
Activity Hubs.
Dementia and Technology
The purpose is to explore the possibilities for
technology interventions for dementia to make
founded decisions for the use of technology in
the healthcare. In different projects will be used
to look at the self-care, quality of life, assistance
Nijhof, Nienke
for family caregivers, feeling of safety and work
Universiteit Twente, Enschede
satisfaction for the person with dementia, the
The Netherlands
family caregivers and the professional
caregivers. Within this research there also will
be looked at the possible financial advantages
with technology for people with dementia. Due
to the different projects there will be input for a
business model.
199
Oberzaucher, Johannes
CEIT RALTEC, Schwechat
Austria
Oppenauer, Claudia
Department of Clinical, Biological and
Differential Psychology, Faculty of Psychology,
University of Vienna
Austria
Páli, Viktor
Faculty of Electrical Engineering and
Informatics, Budapest University of Technology
and Economics
Hungary
Extramural Gait Analysis with an In-Shoe
Measurement System
The goal is to realize a system for a gait
classification by in-shoe measurement and
automated computer-aided interpretation of
spatiotemporal gait-parameters. By using
different classification-methods it will be
evaluated if it is possible to use the extracted
gait parameters to classify whether a person has
an increased risk of falling or not.
Psychological Variables in Technology
Acceptance of Older Adults by Means of
Internet Use
A prevalent approach to explain technology use
is the Technology Acceptance Model (TAM).
Studies indicate that the Selection, Optimization
and Compensation (SOC) model by Baltes and
Baltes which describes a successful coping
strategy in old age is able to explain technology
adaption in older persons. Consequently, an
extended TAM version including health and
psychological needs and SOC strategies is
evaluated in an online survey dealing with
internet use among German language 60+ years
adults.
MeReA - Medication Reminder Assistant
The goal is to develop an open source program
to solve the problems of purchasing and taking
various medicaments by patients who often live
with limited abilities. MeReA aims to provide
them with all the necessary and important
information in due time and through the proper
channel. Since it is deemed important to study
the long-term tendencies from a medical
doctor’s point of view, MeReA will allow also
such examinations in addition to the medication
reminder function.
200
Sack, Martijn
Department of Distributed and Mulitmedia
Systems, Faculty of Computer Science,
University Vienna
Austria
Salminen, Juho
Lahti School of Innovation, Lappeenranta
University of Technology
Finland
Soutschek, Stefan
Department of Psychiatry,
Erlangen-Nürnberg
Germany
University
of
Spiegl, Werner
Department of Computer Science, University of
Erlangen-Nürnberg
Germany
AMASL - Ambient Assisted Shared Living
AMASL is based on the integration of
technologies
as
audio-video
systems,
sensors/actors,
and
distributed
systems
knowledge. The outcome of the project AMASL
aims at three classes of applications: first,
elderly people should be socially included;
second, relatives or care taking organizations
should have the possibility to provide help for
daily routines; third, there should be audiovisual support in case of emergency, which can
be used by authorized people such as care takers
and relatives.
Applying Collective Intelligence for Idea
Evaluation at the Front End of Innovation
Principles of collective intelligence were
applied in an idea evaluation tool, a prototype of
which was then tested in a case organization.
The prototype was able to evaluate ideas
effectively and it was highly accepted in the
organization. A similar tool could also be
applicable for capturing the ideas and
knowledge of elderly people in order to increase
the usability of solutions developed to improve
their quality of life.
InformARTik:
Technology,
Art
and
Communication
"InformARTik" focuses on intuitive interfaces
between elderly people and the integrated
technologies. The aim is to utilize artwork as
access to modern communication technology
and additionally to use it as transportation
vehicle for clinical relevant data. Within this
project new and innovative methods are
developed to direct the attention especially of
elderly people to clinically relevant areas, to
impart knowledge and to offer screening and
diagnostic instruments.
Speech Controlled Home Assistance System
for Elderly People
To elongate the independency of elderly people
at home a home-assistance system comes in
handy, which integrates available technology in
the accommodation to support seniors in their
everyday life. The core of the proposed home
assistance system is a dialog system, which
allows a comfortable and intuitive interaction
through spontaneous speech.
201
Behavior Monitoring in Ambient Assisted
Living
One part of behavior monitoring is the detection
of short-term deviations from the typical
behavior of the assisted person which may
Storf, Holger
indicate a critical emergency situation. Another
Fraunhofer-Institute for Experimental Software
important part of behavior monitoring is the
Engineering, Kaiserslautern
detection of long-term deviations in the persons
Germany
behavior which may indicate typical diseases of
elderly persons. Therefore it is important to
detect characteristic activities in the person’s
life like the so called Activities of Daily Living
(ADL).
Szabó, Tamás
Faculty of Electrical Engineering and BPMA and DiScA: Blood Pressure Monitor
Informatics, Budapest University of Technology and Dietetic Scale & Recipe Book Assistants
and Economics
See project description above (Gulyás, Máté).
Hungary
Sznyida, Róbert
Faculty of Electrical Engineering and
MeReA - Medication Reminder Assistant
Informatics, Budapest University of Technology
See project description above (Páli, Viktor).
and Economics
Hungary
Tomasi, Lorenzo
Casattenta (Aware Home)
The Laboratory for ICT Technologic Transfer
See project description above
(T3Lab) in Bologna
(Bordoni, Alberto).
Italy
Liberty and Absence of Grounds for
Disqualification in Life - Safe and
Changeable Kitchen
This research project aims to respond the needs
Törne, Mari
of society that supports everyone for
Satakunta University of Applied Sciences
independent and unrestricted life in every stage
Finland
of life span. The focus of this research project is
developing changeable kitchen that is suitable
for elderly people and people with different
disabilities.
Personal Electronic Nurse - Medical
Monitoring System
The primary goal of this study is to establish
real time monitoring of the patient’s vital signs
Tóth, András
Institute for Applied Telecommunication in a system called the Personal Electronic Nurse
Technologies, Bay Zoltán Foundation for (PEN). The biomedical data for each patient, are
Applied Research, Budapest
preprocessed on the PEN Mobile Device and
Hungary
transmitted to a Data Collection System using
wireless communication and embedded
technologies. The other goal of the system is to
monitor patients’ activity.
202
Urdaneta, Elena
Tele-Monitoring Tools for the Improvement
Instituto Gerontológico Matía - INGEMA,
of Assistance in Alzheimer's Disease
Donostia - San Sebastián
See project description above (Buiza, Cristina).
Spain
ATTEND
Within the scope of the project ATTEND a
system will be developed that comprises an
intelligent, adaptive network of sensors, which
are to be installed in the living environment of
Yin, GuoQing
Institute of Computer Technology, Faculty of the user in order to thoroughly observe his
Electrical
Engineering
and
Information behavior. The system is intended to increase
Technology, Vienna University of Technology
comfort, security and social inclusion of the
Austria
customer and ideally also help with the early
detection of upcoming medical problems. In
case of an emergency the system can contact
primary and secondary users (family, neighbor,
care giver) via external interfaces.
Agent
Assisted
Web
Accessibility
Enhancement for Ageing Population
The major contributions of the thesis are the
formalisation and conceptual integration of
Zakraoui, Jesia
three resources: the concept of an automatic
Institute "integrated study", Vienna University
generation of User’s context, User Interface and
of Technology
Interaction Modalities ontologies. These
Austria
resources serve as a basis knowledge for User
interface adaptation and the concept of
ontology-based communication among a set of
agents.
203
PARTICIPANTS
Lastname
Blessing
Firstname
Agatha
Company
agatha limited
City
abidjan
Country
France
Aguiar
Ana
Fraunhofer Portugal AICOS Porto
Portugal
Aigner
Alaiza
Walter
Javier
Vienna
Zaragoza
Austria
Spain
Ala-Nikkola
Merja
Hämeenlinna
Finland
Ala-Siuru
Allahwerdi
Alvarez Osuna
Pekka
Helena
Javier
HiTec Marketing
Ibernex Ingenieria S.L.
Hamk University of
Applied Sciences
University of Oulu
Active Seniors Ass.
IMAXDI
Raahe
Espoo
Vigo
Finland
Finland
Spain
Palmanova
Italy
Antonini
Giulio
Azienda sanitaria 5 Bassa
Friulana on behalf of
Regione Autonoma Friuli
Venezia Giulia- Central
Dire
Aquilano
Michela
Scuola Superiore Sant'Anna Pontedera
Italy
Arnestad
Maja
Rsearch Council of Norway Oslo
Norway
Asensio
Puerto
Fundación Vodafone
España
Alcobendas
Madrid
Spain
Asikainen
Paula
Satakunta Hospital District
Pori
Finland
Aubin
Vladimir
COMMUNICARTES
RENNES
France
Aubry
Francois
Independent
Saint Germain
en Laye
France
Avci
Akin
University of Twente
Hengelo
Netherlands
Bako
Istvan
Bay Zoltán Foundation for
Applied Research-IKTI
Budapest
Hungary
Ballesteros
Soledad
UNED
Madrid
Spain
204
Bamidis
Panagiotis
Research Committee AUTH Thessalonik
Greece
Barlow
James
Peter
Rémi
Ulrich
Edoardo
Imperial College Business
School
MFKK Kft.
IRIT
Robert Bosch GmbH
Forus srl
United
Kingdom
Hungary
France
Germany
Italy
Bartal
Bastide
Behner
Benelli
Benito
Santiago
Instalaciones Inabensa, S.A. Madrid
Spain
Benoit
Deniau
saint mande
France
Bergmann
Neil
clear vista
The University of
Queensland
Queensland
Australia
Bernardos
Ana M.
Technica University of
Madrid
Madrid
Spain
Bernert
Christa
Federal Ministry of
Transport, Innovation and
Technology
Vienna
Austria
Besters
Bieber
Michiel
Daniel
Bjørneby
Sidsel
Bjørvig
Siri
Norwegian Centre for
Integrated Care and
Telemedicine
Tromsø
Boire
Jean-Yves
ANR
Paris
Bordoni
Alberto
T3LAB
Bologna
France,
Metropolitan
Italy
Børner
Thomas
Ministry of finance
Copenhagen K
Denmark
Bosch
Stephan
Enschede
Netherlands
Bossart-Weiss
Margrit
University of Twente
Swiss council of senior
citizens ""SSR-CSA"
Berne
Switzerland
Boye
Niels
Brussels
Belgium
Brandstötter
Michael
Wien
Austria
Brandt
Åse
Århus C
Denmark
Brandt
Bratvold
Alexander
Astrid
Berlin
Tromsoe
Germany
Norway
London
Budapest
Toulouse
Waiblingen
Palermo
Rathenau Institute
The Hague
iso-Institut Saarbrücken
Saarbrücken
GERIA, Dementia Resource
Oslo
Centre
CMU AAL-Joint
Programme
CogVis gmbh
Danish Centre for Assistive
technology
Mediber GmbH
UNN
205
Netherlands
Germany
Norway
Norway
Brenner
Werner
Brenner
Breuer
Breuil
Brusell
Hilel
Pál
Fanny
Tomas
Buber-Ennser
Isabella
Buchinger
Clemens
Buciova
Vienna University of
Technology, Institute of
Sensor and Actuator
Systems
Wien
Austria
Omer
Budapest
MATARO
Kongsberg
Israel
Hungary
Spain
Norway
Vienna
Austria
WU Wien, FI
Altersökonomie
Wien
Austria
Maria
Slovenska technicka
univerzita v Bratislave
Bratislava
Slovakia
Cristina
Fundación Instituto
Gerontologico MatiaIngema
San Sebastian
Spain
Darko
Republic of Slovenia,
Ministry of high education,
science and technology
Ljubljana
Slovenija
Burgsteiner-Schroeder Petra
Bundesministerium für
Arbeit, Soziales und
Konsumentenschutz
Wien
Austria
Burkow
Tatjana
Norwegian Center for
Integrated Care and
Telemedicine, University
Hospital of North Norway
Tromsø
Norway
Butler
Gerard
Enterprise Ireland
Ireland
Cabestany
Joan
UPC-CETpD
Capello
Carlo
Capobianco
Michele
Castrosin
Juan Carlos
Politecnico di Torino
ONDA Communication
S.p.A.
Pi&Pi
Dublin 3
Vilanova i la
Geltru
Turin
Roveredo in
Piano (PN)
Madrid
Cavallo
Filippo
Scuola Superiore Sant'Anna Pontedera
Italy
Cebreiros Fernandez
Ceinos
Celibert
Christodoulou
Javier
Carmen
Claude
Eleni
Info JC S.L.
Ecomit Consulting
CMC/MAD Magazine
Citard Services Ltd
Spain
Spain
France
Cyprus
Buiza
Bulat
Medica Healh Institute
BME EMT
CETEMMSA
Brusell Dental AS
Vienna Institute of
Demography
206
Vigo
Barcelona
CAUDAN
Nicosia
Spain
Italy
Italy
Spain
Christopher
Mayer
Clemensen
Colome
Jane
Josep Maria
AIT Austrian Institute of
Technology GmbH
MedCom
i2CAT Foundation
Conci
Mario
Coradeschi
Corbiere
Wr. Neustadt
Austria
Odense C
Barcelona
Denmark
Spain
Fondazione Bruno Kessler
Trento
Italy
Silvia
Thierry
Örebro University
ADVANSEE
Sweden
France
Cottereau
Thomas
ARELIA
Crespo
Crespo Miguel
Cruz
Cruz Martin
Luis Felipe
Mario
Nuno
Elena
Universidad de Cadiz
University of Cadiz
Meticube
Telefonica I+D
Örebro
Nantes
CESSON
SEVIGNE
Cadiz
Cadiz
Coimbra
Granada
Csanyi
Miklos
Mobility and Multimedia
Nonprofit Ltd.
Budapest
Hungary
Cuno
Silke
Fraunhofer-Institute
FOKUS
Berlin
Germany
Curry
Richard
Technology Strategy Board 7JA
Curry
Christopher
Critical Data Ltd
Cambridge
Daar
Hadas
ISERD
Tel-Aviv
Dario
Paolo
Scuola Superiore Sant'Anna Pisa
Italy
Darvish
De Andrés-Medina
Nissim
Rafael
Herzelia
Madrid
Israel
Spain
De Bruïne
Frans
Pitango Venture Capital
ISCIII
International Strategy
Consultants
Hoeilaart
Belgium
De Buenaga
Manuel
De Vusser
De Witte
Deboutte
Del Arbol Perez
Frederik
Luc
Peter
Luis Pablo
Del Hoyo
Rafael
Dettwiler
Diermaier
Paul
Josef
France
Spain
Spain
Portugal
Spain
United
Kingdom
United
Kingdom
Israel
Universidad Europea de
Madrid
Villaviciosa de
Spain
Odón - Madrid
IWT
Hogeschool Zuyd
vzw In-HAM
Telefonica I+D
Instituto Tecnologico de
Aragon
ZHAW
CEIT Raltec
Brussels
Heerlen
Gits
Granada
Belgium
Netherlands
Belgium
Spain
Zaragoza
Spain
Wädenswil
Schwechat
Switzerland
Austria
207
Dihanits
Wolfgang
Arbeiter-Samariter-Bund
Österreichs
Wien
Austria
Donati
Carlo
Ministry of Labour, Health
and Social Policies
Roma
Italy
Dunkerton
Sue
HealthTech & Medicines
KTN
Cambridge
United
Kingdom
Durá
Juan Vicente
ASOC. INST.
BIOMECANICA
VALENCIA
VALENCIA
Spain
Duss
Marcel
Lucerne University of
Applied Sciences and Arts
Horw
Switzerland
Egloff
Daniel
Federal Office for
Professional Education and
Technology OPET
Berne
Switzerland
Eichelberg
Marco
OFFIS
Oldenburg
Germany
Eikhaug
Onny
Norwegian Design Council
oslo
Norway
Elias
Dirk
Fraunhofer Portugal AICOS Porto
Portugal
Elleby
Anders
Swisscom AG
Participations
Worblaufen
Switzerland
Enste
Peter
IAT
Gelsenkirchen
Germany
Erharter
Dorothea
Wien
Austria
Erkert
Thomas
Zürich
Switzerland
Espeli
Tron
Oslo
Norway
San Sebastian
Spain
ZIMD, Humanistische
Plattform
DocSwiss
Research Council of
Norway
Etxeberria
Igone
Fundacion Instituto
Gerontologico MatiaINGEMA
Falavigna
Fanucci
Mirko
Luca
T3LAB
University of Pisa
Bologna
Pisa
Italy
Italy
Felbo
Olav
DaneAge Association
Copenhagen K
Denmark
Felnhofer
Anna
Institut für Klinische,
Biologische und
Differentielle Psychologie
Wien
Austria
Finking-Astroh
Annegret
AAL Association
Bonn
Germany
208
Flim
Chris
Flim PC
Utrecht
Netherlands
Floeck
Martin
TU Kaiserslautern
Kaiserslautern
Germany
Fragoso
Bruno
UMIC - The Knowledge
Society Agency
Porto Salvo
Portugal
Frisch
Harald
Robert Bosch Healthcare
GmbH
Waiblingen
Germany
Gachet
Diego
Universidad Europea de
MAdrid
villaviciosa de
odón
Spain
Gaedt
Lone
Odense M
Denmark
Gaisbauer
Christian
Wien
Austria
Gälle
Doris
Klagenfurt
Austria
Gaudron
Dominique
ALGOE
BRON
Georgieff
Gerard
Geyer
Glenck
Goebl
Peter
Baubau
Gerda
Emmanuel
Reinhard
Karlsruhe
RENNES
Vienna
Wien
Vienna
Gougon
Jean-Marc
LANNION
France
Grgurić
Andrej
Fraunhofer ISI
MEITO
FFG
FFG
BMVIT
ENSSAT-FOTON, groupe
CAPT
Ericsson Nikola Tesla
France,
Metropolitan
Germany
France
Austria
Austria
Austria
Zagreb
Croatia
Gronbaek
David
Gross
Sara
Grundei
Friedrich
Guggenbühl
Urs
Fachhochschule St.Gallen,
Innovationszentrum
Gulyas
Mate
Biomedical Engineering
Knowledge Centre,
Budapest
Budapest University of
Technology and Economics
Günzler
Rainer
HSG-IMIT
Danish Technological
Institute
BMVIT
Alpen Adria Universität
Klagenfurt
Danish Agency for Science,
Copenhagen K
Technology and innovation
Die Presse
Seniorenbüro der Stadt
Wien
209
Denmark
Wien
Austria
Wien
Austria
St. Gallen
Switzerland
VillingenSchwenningen
Hungary
Germany
Hafner
Ottfried
European News Agency
Wien
Austria
Hainschink
Bettina
Conect Journal
Wien
Austria
Hallenborg
Kasper
University of Southern
Denmark, Maersk Institute
Odense C
Denmark
Hamilton
Peter
Vienna
Austria
Hanák
Péter
Budapest
Hungary
Haritou
Maria
Institute of Communication
Athens
and Computer Systems
Greece
Harju-Autti
Pia
Tekes-Finnish Funding
Agency for Technology and HELSINKI
Innovation
Finland
Harmo
Panu
Haslinger
Wolfram
Helsinki University of
Technology
Student
Hastall
Matthias
VU University Amsterdam
HV Amsterdam Netherlands
Häusler
Elisabeth
Salzburg Research
Forschungsgesellschaft
mbH
Salzburg
Austria
Havinga
Paul
University of Twente
Enschede
Havlík
Jan
FEE CTU in Prague
Prague 6
Netherlands
Czech
Republic
Hechl
Elisabeth
Federal Ministry of Labour,
social Affairs ans Consumer Vienna
Protection
Hegerstrøm
Heine
Flemming
Thomas
Heinonen
Tarja
Helene
Morin
Helfenbein
Hellmich
Hempel
Henriksen
AIT Austrian Institute of
Technology
BME EMT
Hospital IT
University of Tübingen
PIRAMK University of
Applied Sciences
Espoo
Finland
Linz
Austria
Austria
Oslo
Tübingen
Norway
Germany
Tampere
Finland
BRETAGNE
INNOVATION
RENNES
France
Tamás
Bay Zoltán Foundation for
Applied Research - IKTI
Budapest
Hungary
Petra
Benjamin
Eva
Samariterbund Wien
Exozet Berlin GmbH
FOU äldre norr
Wien
Berlin
Järfälla
Austria
Germany
Sweden
210
Hernández
Mario
Hilbert
Anette
Hirschberg
Ganit
Hirvikoski
Tuija
Hlavacs
Helmut
Höckner
Klaus
Hoerl
Josef
Hofer
Silvia
Holsøe
Peter
Holzinger
PLANET MEDIA
VDI/VDE Innovation +
Technik GmbH
eSeniors
Laurea University of
Applied Sciences
Univ. of Vienna
Madrid
Spain
Berlin
Germany
Paris
France
Kerava
Finland
Vienna
Austria
Hilfsgemeinschaft der
Blinden und Sehschwachen Wien
Österreichs
Wien
Austria
Wien
Austria
Danish Ministry of Science
Copenhagen
Denmark
Andreas
Medical University Graz &
Austrian Computer Society
Graz
Austria
Hoppe
Annette
VDE
Frankfurt
Germany
Hribernig
Christian
Alcatel-Lucent Austria AG
Wien
Austria
Huch
Huttunen
Ibáñez De Aldecoa
Quintana
Michael
Teemu
AAL Association
Videra Ltd
Ministerio de Industria,
Turismo y Comercio
Brussels
Espoo
Belgium
Finland
MADRID
Spain
Lefkosia
Cyprus
OULU
Schwechat
Bregenz
RENNES
Berlin
Finland
Austria
Austria
France
Germany
Juan Miguel
Vienna University
Wellness Guide
(MediaGuide Verlag)
Austria
Research Promotion
Foundation
VTT
CEIT RALTEC
SAM Headhunting
Critt Santé Bretagne
Fraunhofer FIRST
Ioulianos
Antonis
Isomursu
Jagos
Jansen
Jocelyne
John
Minna
Harald
Stephan
Golven
Michael
Johnsen
Elin
NST, University hospital of
Tromsø
North Norway
Norway
Jonkers
Karianne
The Netherlands
Organisation for Health
Research and Development
Den Haag
Netherlands
Jung
Jyrkkiö
Erik
Armi
Fraunhofer IZM
Laurea
Berlin
Vantaa
Germany
Finland
211
Kaarnasaari
Anne
Nordic Healthcare Group
Helsinki
Finland
Kahri
Pekka
Tekes
Helsinki
Finland
Kaiser
Iris
Medical University of
Vienna, Department of
Neurosurgery
Wien
Austria
Kanto-Hannula
Tujia
YH Länsi Oy
Tampere
Finland
Kardon
Béla
Bay Zoltán Foundation for
Applied Research-IKTI
Budapest
Hungary
Karisto
Antti
Department of Social
Policy, University of
Helsinki
Helsinki
Finland
Karkowski
Kastner
Kasza
Katzmaier
Irek
Matthias
Attila
Sabine
The Hague
Wien
Budapest
Linz
Netherlands
Austria
Hungary
Austria
Kempas
Kari
Lahti
Finland
Kervella
Philippe
Douarnenez
France
Kettunen
Aija
Pieksämäki
Finland
Kilias
Dimitrios
Rhodes
Greece
Kishna
Sita
The Hague
Netherlands
Kiss
Norbert
Budapest
Hungary
Kistler
Rolf
Lucerne University of
Applied Sciences and Arts
Horw
Switzerland
Kivikunnas
Sauli
VTT
Oulu
Finland
Klapproth
Alexander
Lucerne University of
Applied Sciences and Arts
Horw
Switzerland
Knapp
Benjamin
Queen's University
Belfast
United
Kingdom
Undine
Norwegian Centre for
Integrated Care and
Telemedicine
Berlin
Germany
Knarvik
TNO
FH Technikum Wien
BME-EMT
FH OÖ Campus Linz
LUT Lahti School of
Innovation
LAGASSE
TECHNOLOGIES
Diakonia University of
Applied Sciences
RTEL SA
Ministry of Health Welfare
and Sport
BME EMT
212
Konstantinidis
Evdokimos
Lab of Medical Informatics,
Aristotle University of
Thessaloniki
Thessaloniki
Greece
Kosiedowski
Michal
Institute of Bioorganic
Chemistry Polish Academy Poznan
of Sciences
Poland
Kothgassner
Kovacs
Kovácsházy
Kreiner
Kremser
Oswald
Eleonora
Tamás
Andreas
Willibald
Krenn
Manfred
Kristensen
Jeppe
Kroustrup
Jonas
Krukowska
Marta
The University of Dundee
Dundee
Kryspin-Exner
Kuhn
Ilse
Alexandra
Wien
Wien
Kunze
Christophe
University of Vienna
bmvit
FZI Forschungszentrum
Informatik
United
Kingdom
Austria
Austria
Karlsruhe
Germany
Kurschl
Werner
Upper Austria University of
Hagenberg
Applied Sciences
Austria
Kurzmann
Andreas
PCS Professional Clinical
Software GmbH
Klagenfurt am
Wörthersee
Austria
Kusk
Dorthe
Kirsten
Regional Development
Vejle
Denmark
Kuvaja-Köllner
Virpi
Diaconia University of
Applied Sciences, Research
Pieksämäki
Centre for Social
Economics
Finland
Laakso
Anne
Hämeen
ammattikorkeakoulu
Hämeenlinna
Finland
Lablans
Martin
Universitätsklinikum
Münster
Münster
Germany
Lagerwall
Tomas
SIAT - Swedish Institute of
Vällingby
Assisitive Technology
University of Vienna
GE Healthcare
BME EMT
Modernfamilies
OCG
AIT Austrian Institute of
Technology
Regional Development
Danish Technological
Institute
213
Wien
Budaörs
Budapest
Linz
Wokersdorf
Austria
Hungary
Hungary
Austria
Austria
Wien
Austria
Vejle
Denmark
Aarhus
Denmark
Sweden
Langerveld
Langzauner
Geja
Gabriele
ZonMw
BMVIT
Larrañeta
Jose Javier
Spanish Technological
Platform on Industrial
Security.
Larsen
Anne
Hoegdal
Danish Society of Engineers Copenhagen V. Denmark
Lavaste
Olivier
UR1-CNRS et Sens-Innov
RENNES
France
Lazelberger
Erich
Austrian Institute of
Technology
vienna
Austria
Leeson
George
University of Oxford,
Oxford Institute of Ageing
Oxfordshire
United
Kingdom
Lefebvre
Anne-Sophie
Handelsabteilung der fr.
Botschaft
WIEN
Austria
Lehtovuori
Lili
Finpro, Finnische Botschaft Wien
Leibovici
Irena
Leitner
Leitner
Leonard
Gerhard
Paul
Stéphanie
Ana ASLAN International
Foundation
Klagenfurt University
MediaServices GmbH
REIMP'HOS
Levene
Peter
Docobo Limited
Bookham
Lilgenau
Anneliese
Universität Wien/ Institut
für Pflegewissenschaft
Wien
Austria
Litzenberger
Martin
AIT Austrian Instiute of
Technology GmbH
Wien
Austria
Lodwig
Volker
Roche Diagnostics GmbH
Lampertheim
Germany
Löfqvist
Charlotte
Lund university
Lund
Sweden
Loretz
Johannes
Fachhochschule Kärnten
Spittal/Drau
Austria
Ludwig
Wolfram
Peter L. Reichertz Institut
für Medizinische Informatik
Braunschweig
der TU Braunschweig und
MH Hannover
Germany
Macagnano
Ennio
Council for Scientific and
Industrial Research
South Africa
214
Den Haag
Wien
Netherlands
Austria
Spain
Austria
BUCHAREST
Romania
Klagenfurt
Anif
ISLE
Austria
Austria
France
United
Kingdom
Pretoria
Magalhães
Luis
Malmi
Mancin
Manzo
Margelí
Marin-Perianu
Seppo
Silvia
Gabriele
Mªcarmen
Mihai
Knowledge Society
Agency, Portugal
YH Länsi Ltd
ARSENAL.IT
TRACS Srl
CETEMMSA
Inertia Technology
Marin-Perianu
Irina
Marin-Perianu
Porto Salvo
Portugal
Tampere
TREVISO
TRECASE
Mataró
Enschede
Finland
Italy
Italy
Spain
Netherlands
PROSYS PC SRL
BUCHAREST
Romania
Raluca
University of Twente
Enschede
Marshall-Cyrus
Jacqueline
Technology Strategy Board Swindon
Martinez
Alberto
ROBOTIKER-Tecnalia
ZAMUDIO
Netherlands
United
Kingdom
Spain
Martinez
Llopart
FIRA DE BARCELONA
BARCELONA Spain
Martinez Suarez
Leonardo
CETIEX - FUNDACION
CENTRO TECNOLOGICO
INDUSTRIAL DE
EXTREMADURA
Martins
Angelo
Matolin
Daniel
Matwijow
Marta
Mayr
Erich
Mayr
Margit
Megyesi
Csaba
Meleg
INESC PORTO
Austrian Institute of
Technology
Spain
465 Porto
Portugal
Vienna
Austria
Worblaufen
Switzerland
Wels
Austria
Linz
Austria
Bay Zoltán Foundation for
Applied Research-IKTI
Budapest
Hungary
László
Meditech Kft
Budapest
Hungary
Menard
Christian
Fachhochschule Kärnten
Klagenfurt
Austria
Mendgaard-Larsen
Mescheder
Mieling
Nicolai
Ulrich
Helga
Regional Development
Hochschule Furtwangen
BMVIT
Vejle
Furtwangen
Vienna
Milligan
Christine
Lancaster University
Lancaster
Denmark
Germany
Austria
United
Kingdom
Miralles
Felip
Barcelona Digital Centre
Tecnològic
Barcelona
Swisscom AG
Participations
FH OÖ Forschungs- &
Entwicklungs GmbH
FH OÖ Campus Linz
215
Spain
Mirella
Benes
consorzion per l'area di
ricerca scientifica e
tecnologica di trieste
Mobbs
Graham
Technology Strategy Board Swindon
Molina Cabrera
Daniel
Monnat
Andreea
Gesfor Group
Fonds National de la
Recherche
Mordini
Emilio
Moreno
Morlion
Sofia
Birgit
Centre for Science, Society
and Citizenship
AETIC
IBBT vzw
Mort
Maggie
Lancaster University
Moser-Siegmeth
Verena
Mosmondor
Miran
Research Institute of the
Red Cross
Ericsson Nikola Tesla
Muehlfeit
Jan
Microsoft
Muñoz Machado
Andrés
MADRID POLYTECHNIC
MADRID
UNIVERSITY (UPM)
Spain
Nadège
Cartier
Critt Santé Bretagne
RENNES
France
Narro Artigot
Elvira
NET 2 YOU, S.L.
ZARAGOZA
Spain
Nelson
John
University of Limerick
Neves
Ana
Nieke
Nielsen
Nijhof
Philipp
Claus
Dorte
Dalkjær
Nienke
Nimylowycz
Igor
LIMOUSIN EXPANSION
Nissinen
Pasi
Norvapalo
Kare
Videra Ltd.
JAMK University of
Applied Sciences
Obach
Michael
Oberzaucher
Johannes
Nielsen
Trieste
Italy
Madrid
United
Kingdom
Spain
Luxembourg
Luxembourg
ROME
Italy
MADRID
Gent
Spain
Belgium
United
Kingdom
Lancaster
Vienna
Austria
Zagreb
Croatia
Czech
Republic
Prague
Limerick
122 Porto
Knowledge Society Agency
Salvo
FH Technikum Wien
Wien
MedCom
Odense C
Austria
Denmark
Regional Development
Vejle
Denmark
University of Twente
Utrecht
LIMOGES
CEDEX
Espoo
Netherlands
France
Jyväskylä
Finland
FATRONIK-Tecnalia
Donostia-San
Sebastián
Spain
Ceit Raltec
Wien
Austria
216
Ireland
Portugal
Finland
Odnoletkova
Irina
Olsson
Silas
Op Den Akker
Harm
Independant Health
Insurance Funds
AALA
Roessingh Research and
Development
Brussel
Belgium
Brussels
Belgium
Enschede
Netherlands
Vienna
Austria
SAN
SEBASTIAN
Spain
Oppenauer
Claudia
University Vienna, Faculty
of Psychology, Institute of
Clinical, Biological and
Differential Psychol
Ormazabal
Miguel
CEIT
Österle
Hubert
St. Gallen
Switzerland
Ostlund
Britt
Danderyd
Sweden
Páli
Palicska
Viktor
Krisztina
Budapest
Budapest
Hungary
Hungary
Palmer
Ross
Carlow
Ireland
Pantelopoulos
Stelios
N. Ionia
Greece
Parent
Anne-Sophie
Universität St. Gallen
Lund University and R&D
Seniorium
BME EMT
MFKK Kft.
Institute of Technology,
Carlow
SingularLogic S.A.
AGE-the European Older
People's Platform
Bruxelles
Belgium
Parker
Charles
Continua Health Alliance
Belton
United States
Parkkinen
Pastol
Mikko
Francois
Carmen
Naarajärvi
Lannion
Zamudio
(Bizkaia)
Finland
France
Pastor
ActiveSoft Oy
INNOVTEL
TECNALIA Health &
Quality of Life
Patty
Justin
"Europeans" project
DUNDONALD
Paugger
Helmut
academia nova GmbH
Schwechat
United
Kingdom
Austria
Pavan
Gianmaria
Onda Communication spa
Pordenone
Italy
Pecora
Federico
Örebro
Sweden
Perälä
Jukka
Örebro University
VTT Technical Reseach
Centre of Finland
Tampere
Finland
Perez
Carmen
Seville
Spain
Perez Alcazar
Petäkoski-Hult
Ignacio
Tuula
Malaga
Tampere
Spain
Finland
Consultores
Euroamericanos Asoc.
I2BC
VTT
217
Spain
Pianesi
Fabio
Fondazione Bruno Kessler
Povo
Italy
Pietquin
Olivier
Metz
France
Pinter
Pal
Budapest
Hungary
Plößnig
Manuela
SUPELEC
Hungarian Osteoporosis
Patient Association
Salzburg Research
Salzburg
Austria
Pohlmeyer
Anna
University of Luxembourg
Berlin
Germany
Polymenakos
Lazaros
Athens Information
Technology
Peania
Greece
Pommet
Raymond
CEA - ANR Management
Unit
GIF SUR
YVETTE
CEDEX
France
Prenner
Tanja
Wien
Austria
Prwtopapas
Pujol
Kosmas
Laia
TU Wien Institut Integriert
Studieren
RTEL SA
I2BC
Greece
Spain
Purcarea
Octavian
Microsoft
Greece
MALAGA
Issy Les
Moulineaux
Puurtinen
Hanna-Greta
PIRAMK University of
Applied Sciences
Ragib
Delic
B&HNEWSWIEN
Mag@zin/www.nasarijec.ba
BosniaHerzegovina
Raij
Katariina
Active Life Village LtD
Finland
Rainaldi
Nino
MediaGuide Verlags GmbH Wien
Austria
Rauhala
Marjo
Vienna University of
Technology
Vienna
Austria
Razavi
Reza
FOETZ
Luxembourg
Reales Avilés
Reichel
José Manuel
Martin
Madrid
Wien
Spain
Austria
Reig
Juan
Seville
Spain
Remartinez
Richardson
Antonio
Louise
AAS (Ambient Activity
Systems)
UNED
FH Technikum Wien
Consultores
Euroamericanos Asoc
IBERNEX S.L.
OWN Ireland
Rigby
Kenneth
MellaniuM
PRESTON
Ringers
Risberg
Michiel
Marijke
TNO
UNN
The Hague
Tromsoe
218
Tampere
Espoo
Zaragoza
France
Finland
Spain
9 Ireland
United
Kingdom
Netherlands
Norway
Ritterfeld
Ute
VU University Amsterdam
Roedl
Lukas
Roelofsma
Peter
AIT Austrian Institute of
Technology
CAMeRA Uilenstede
Roessler
Daniel
PNO Consultants GmbH
Romeu
Laura
Rumm
Peter
Ryhänen
Frank
Saccavini
Sack
Claudio
Martijn
Sacken
Alexander
Sala
Salazar
Pilar
Jesus
Salerno
Christian
Salinas
Jose Ramon
Salminen
Juho
Lappeenranta University of
Technology Lahti School of Lahti
Innovation
Finland
Santos
Antonio
UMIC - The Knowledge
Society Agency
Porto Salvo
Portugal
Saraga
Peter
OPE
London
Sarkar
Ranjana
Bonn
Savvides
Marinos
Nicosia
Cyprus
Scheitz
Schildorfer
Walter
Wolfgang
GRAZ
Vienna
Austria
Austria
Schips
Bernd
St. Gallen
Switzerland
Schmidt
Schneider
Stefan
Cornelia
Wien
Salzburg
Austria
Austria
Schneider
Ulrike
PT-DLR
A.M.D Assistive Networks
Ltd
FH JOANNEUM
Hitec Marketing
Fachhochschule St.Gallen,
IZSG
FH Technikum Wien
Salzburg Research
WU Wien, FI
Altersökonomie
United
Kingdom
Germany
Wien
Austria
DZA, German Centre of
Gerontology
FutureCamp GmbH
Culminatum Innovation Oy
Ltd
ARSENAL.IT
University of Vienna
Bosch Sicherheitssysteme
GmbH
ITACA
SIEMENS S.A.
CONSOFT SISTEMI
S.p.A.
Fundacion CITIC
219
Amsterdam
Netherlands
Wr. Neustadt
Austria
Amsterdam
Netherlands
Wien
Austria
Berlin
Germany
Munich
Germany
ESPOO
Finland
TREVISO
Wien
Italy
Austria
Ottobrunn
Germany
Valencia
GETAFE
Spain
Spain
Torino
Italy
Malaga
Spain
Schoen
Christian
I.T.I
Rueil
Malmaison
France
Schoitsch
Erwin
AIT Austrian Institute of
Technology
Wien
Austria
Schuurman
Jan Gerrit
University of Lincoln
Lincoln
United
Kingdom
Schwarz-Woelzl
Maria
Zentrum fuer Soziale
Innovation
Vienna
Austria
Seewald
Beate
Reha-Zentrum Lübben
Seiding
Henning
Odense Municipality
J. Artur
Norwegian Centre for
integrated care and
Telemedicine
Tromso
Norway
Siciliano
Pietro
Instottue for
Microelectroncis and
Microsystems IMM-CNR
Lecce
Italy
Sigmund
Axel
VDI/VDE Innovation +
Technik GmbH
Berlin
Germany
Serrano
Silva Santos
Paula
Alexandra
Pedro
Silvennoinen
Leena
Simic
Similä
Bojan
Heidi
Silva
Märkische
Heide
Odense M
Germany
Denmark
Fraunhofer Portugal AICOS Porto
Portugal
Microsoft
Culminatum Innovation Oy
Ltd
bonacasa
VTT
Porto Salvo
Portugal
ESPOO
Finland
Solothurn
Oulu
Switzerland
Finland
Simões
Graça
Knowledge Society
Agency(UMIC), Ministry of
Porto Salvo
Science, Technology and
Higher Education
Sivan
Virginie
CEA
Skovgaard
Nanna
The Danish Agency for
Copenhagen K
Governmental Management
Slaninova
Iva
LEVATIO
Krnsko
Soede
Mathijs
VILANS
Utrecht
Gif sur Yvette
cedex
220
Portugal
France
Denmark
Czech
Republic
Netherlands
Sokoler
Tomas
IT Uninversity of
Copenhagen
Copenhagen
Denmark
Sørensen
Jan
University of Southern
Denmark
Odense C
Denmark
Soutschek
Stefan
Erlangen
Germany
Spiegel
Stacey
Oslo
Norway
Erlangen
Germany
University of ErlangenNuremberg
Parallel World Labs Inc
Spiegl
Werner
Lehrstuhl für
Mustererkennung,
Universität ErlangenNürnberg
Spiru
Luiza
"Ana ASLAN"
International Foundation
BUCHAREST
Romania
Spruit
Beppie
Netherlands Institute for
Health promotion
Woerden
Netherlands
Steinberger
Claudia
Alpen Adria Universität
Klagenfurt
Klagenfurt
Austria
Sterrer
Angelika
French Embassy Commercial Section
Vienna
Austria
Storf
Holger
Fraunhofer IESE
Kaiserslautern
Germany
Strehler
Martin
SportKreativWerkstatt
GmbH
München
Germany
Strese
Hartmut
Berlin
Germany
Strömbäck
Lena
Linköping
Sweden
Sylberg
Juha
Helsinki
Finland
Szabo
Tamas
Budapest
Hungary
Szalay
Beata
Budapest
Hungary
Sznyida
Robert
Budapest
Hungary
Tabak
Monique
Enschede
Netherlands
Thomopoulos
Stelios
Athens
Greece
Thum
Werner
Wien
Austria
Thygesen
Hilde
Oslo
Norway
Tind
Tolliner
Mikael
Klaus D.
Odense M
Leoben
Denmark
Austria
VDI/VDE Innovation +
Technik GmbH
Linköpings Universitet
Finnish Federation of the
Visually Impaired
BME EMT
Mobility and Multimedia
Nonprofit Ltd.
BME EMT
Roessingh Research and
Development
NCSR Demokritos
ÖGB ,
PensionistInnenabteilung
Diakonhjemmet University
College
Odense Municipality
Capability
221
Tomasi
Lorenzo
T3LAB
Satakunta University of
Applied Sciences
Bologna
Italy
Törne
Mari
Pori
Finland
Torre
Mari Satur
Madrid
Spain
Tóth
András
Tschopp
Tzovaras
Rahel
Dimitrios
Bay Zoltán Foundation IKTI
CompiSternli
Certh/ITI
Budapest
Hungary
Davos Glaris
Thessaloniki
Switzerland
Greece
Urdaneta
Elena
Fundación INGEMA
San Sebastián
Spain
Uronen
Mia
Helsinki
Finland
Zaragoza
Spain
Eersel
Netherlands
Amsterdam
Netherlands
Ger
Forum Virium Helsinki
Instituto Tecnologico de
Aragon
Smart Homes
Vrije Universiteit
Amsterdam
Philips Research
Val
Javier
Van Berlo
Ad
Van Den Bosch
Misha
Van Den Broek
AE
Netherlands
Van Der Burg
Pauline
Brainport Health Innovation Eindhoven
Netherlands
Van Der Linden
Van Der Vaart
Van 'T Klooster
Barbara
Nina
Jan-Willem
Den Haag
Malaga
Enschede
Netherlands
Spain
Netherlands
Varga
Gerhard
Zonmw
Fundacion CITIC
University of Twente
Prokuratur (Treasury
solicitors)
Wien
Austria
Vasilescu
Andrei
PROSYS PC SRL
BUCHAREST
Romania
Veenstra
Versteeg
Vimarlund
Cor
Leo
Vivian
Amsterdam
Amsterdam
Linköping
Netherlands
Netherlands
Sweden
Vodjdani
Nakita
Amsta
Amsta
Linköping Universitet
Agence Nationale de la
Recherche
Paris
France
Vognild
Lars
Tromsø
Norway
Voncken
Thomas
Sittard-Geleen
Netherlands
Waibel
Uli
Orbis medical and care
group
Innovendo
Wien
Wald
Mike
University of Southampton
Southampton
Austria
United
Kingdom
Wallhoff
Frank
Technische Universität
München
München
Fundación Vodafone
España
Norut - Northern Research
Institute
222
Germany
Wals
Wanche-Politis
Wänke
Jeroen
Sophia
Peter
Philips Research
KMOP
e-m-s-consult
Eindhoven
Kifisia
Linz
Netherlands
Greece
Austria
Wanne
Olli
Satakunta Hospital District
Pori
Finland
Waterworth
Waterworth
Watland
Weber
Wehr
Wehrmann
John
Eva
Håvard
Doris
Mario
Christian
Umeå
Umeå
Oslo
Wien
Klagenfurt
Berlin
Sweden
Sweden
Norway
Austria
Austria
Germany
Weiser
Erentraud
Umeå University
Umeå University
Hospital IT
Universität Wien
FH Kärnten
VDI/VDE-IT
Forschungsinstitut des
Roten Kreuzes
Wien
Austria
Welge
Ralph
Lüneburg
Germany
Werner
Wichert
Wiesmüller
Wintlev-Jensen
Wöhrer
Schwechat
Darmstadt
Vienna
Brussels
Wien
Austria
Germany
Austria
Belgium
Austria
PLRI TU Braunschweig
Braunschweig
Germany
Wolff
Franz
Reiner
Michael
Peter
Maximilian
KlausHendrik
Oliver J.
Massive Art GmbH
Bregenz
Austria
Woodard
Jennifer
Centre de Recerca i
Investigació de Catalunya
Barcelona
Spain
Wraae Silberling
Lise
Region Syddanmark
Vejle
Denmark
Wysoudil
Christian
energy news
Kornwestheim
Germany
Guoqing
Institut für
Computertechnik (ICT),
Vienna University of
Technology
Vienna
Austria
Young
Terry
School of Information
Systems, Computing and
Mathematics / Brunel
University
Uxbridge
United
Kingdom
Yuste
Antonio
Fundació Hospital Sant
Antoni Abat
Vilanova i la
Geltrú
Spain
Zagler
Wolfgang L.
Vienna university of
Technology
Vienna
Austria
Wolf
Yin
Leuphana Universität
Lüneburg
CEIT RALTEC
Fraunhofer Allianz AAL
BMVIT
European Commission
University of Vienna
223
Zakraoui
Jesia
TU-Vienna
Wien
Austria
Zancanaro
Massimo
Fondazione Bruno Kessler
POVO
Italy
Zanesco
Zanetti
Zimmermann
Zottl
Züsli
Antonio
Norma
Kerstin
Sylvia
Richard
Tracs
n/a
BMVIT
HLA Baden
Kanton Zug
Pozzuoli
Pisa
Wien
Baden
Cham
Italy
Italy
Austria
Austria
Switzerland
Zwieschkowski
Olaf
VDE
Frankfurt a.M.
Germany
224